Induration of the cricoid cartilage complicates prosthetic laryngoplasty in a horse.
Authors: Tatarniuk Dane M, Carmalt James L, Allen Andrew L
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Cricoid cartilage induration complicating prosthetic laryngoplasty During a prosthetic laryngoplasty in an 11-year-old gelding with grade IV laryngeal hemiplegia, the surgeon encountered unexpected resistance when attempting to pass a needle through the cricoid cartilage, ultimately resulting in needle breakage before successful placement could be achieved. Post-operative examination revealed hardening of the cricoid cartilage accompanied by diffuse radiopaque speckling on radiographs, though histological analysis surprisingly showed no calcium salt accumulation; instead, substantial proteoglycan loss within the cartilage matrix was identified as the primary structural change. This age-related laryngeal cartilage stiffening mirrors changes documented in both equine and human patients, with proteoglycan depletion and alterations to monomer composition directly responsible for the increased tissue rigidity encountered intra-operatively. For practitioners performing laryngoplasty, pre-operative radiographic screening of the larynx may identify areas of increased radiodensity, though interpretation requires caution as such findings may indicate mineralisation or proteoglycan-related hardening rather than calcium deposition alone. Understanding this degenerative process in older horses—particularly those approaching 10+ years—allows surgeons to anticipate technical challenges, select appropriate needle gauges and instruments, and potentially adjust surgical approach in animals with compromised laryngeal cartilage integrity.
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Practical Takeaways
- •Perform pre-operative radiographic examination of the larynx before prosthetic laryngoplasty to identify areas of increased radiodensity that may indicate cartilage induration and complicate needle passage
- •Be prepared for difficult needle penetration through the cricoid cartilage in older horses; consider using surgical techniques that minimize or avoid direct needle passage through hardened cartilage
- •Understand that radiographic findings of increased density may reflect proteoglycan loss and cartilage stiffening rather than true mineralization, affecting surgical planning
Key Findings
- •Cricoid cartilage induration in an 11-year-old horse caused needle breakage during prosthetic laryngoplasty needle penetration
- •Histologic examination revealed loss of proteoglycans within the cricoid cartilage rather than calcium salt accumulation
- •Radiographic examination showed diffuse radiopaque speckling consistent with laryngeal mineralization associated with advancing age