In vitro effect of ventriculocordectomy before laryngoplasty on abduction of the equine arytenoid cartilage.
Authors: Perkins Justin D, Meighan Hazel, Windley Zoë, Troester Susanne, Piercy Richard, Schumacher Jim
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Ventriculocordectomy Before Laryngoplasty in Horses Recurrent laryngeal neuropathy (RLN) causes significant performance limitation in horses, and whilst prosthetic laryngoplasty (PL) remains the surgical gold standard, outcomes are variable. This in vitro study examined whether removing the vocal cord tissue (ventriculocordectomy) prior to laryngoplasty could improve arytenoid cartilage abduction and therefore airway opening. Using 13 equine cadaver larynges, researchers performed standard PL on one side whilst systematically measuring the force required to maximally abduct the arytenoid cartilage, then repeated measurements after performing ventriculocordectomy on the contralateral side. Combining ventriculocordectomy with laryngoplasty significantly increased both the angle of arytenoid abduction and the cross-sectional area of the rima glottidis (airway opening) compared with PL alone—notably, only 12% of the normal suture force was needed to achieve good abduction angles, and 45% less force was required for optimal airway area. For practising veterinarians, these findings suggest that ventriculocordectomy performed before laryngoplasty could improve surgical outcomes by allowing greater airway patency with reduced tension on the prosthetic suture, potentially decreasing the risk of suture-related complications and improving long-term functionality in RLN cases.
Read the full abstract on PubMed
Practical Takeaways
- •Adding ventriculocordectomy to laryngoplasty may improve rima glottidis opening and reduce suture-related complications by requiring less tension on the prosthetic suture
- •This combined surgical approach could potentially improve airway caliber in horses with laryngeal hemiplegia, though clinical outcomes require in vivo confirmation
- •The mechanical advantage gained may be particularly beneficial in cases where maximum airway opening is desired or where suture-related complications (nerve damage, dehiscence) are a concern
Key Findings
- •Ventriculocordectomy before prosthetic laryngoplasty resulted in significantly greater arytenoid abduction angles (LRQ) and glottic cross-sectional areas (CSAR) compared to laryngoplasty alone (P<0.001)
- •VCE-PL required 12% less force to achieve an LRQ of 0.8 and 45% less force to achieve a CSAR of 0.8
- •Both LRQ and CSAR increased with force application, initially rapidly before plateauing at approximately 50% of maximum force
- •In vitro findings demonstrate ventriculocordectomy before laryngoplasty improves mechanical advantage of the prosthetic technique