Unilateral laser ventriculocordectomy results in increased arytenoid stability in horses with severe left sided recurrent laryngeal neuropathy.
Authors: Baldwin Christopher M, Ireland Joanne L, Barakzai Safia Z
Journal: Equine veterinary journal
Summary
Recurrent laryngeal neuropathy (RLN) causes progressive loss of arytenoid cartilage control during exercise, with grade C and D cases presenting severe functional impairment. Baldwin and colleagues used dynamic endoscopy and quantitative angle measurements to objectively assess whether unilateral laser ventriculocordectomy (VeC)—removal of the vocal fold and associated tissues—improves arytenoid stability in eight horses with severe RLN, measuring left-to-right arytenoid position ratios during both maximal inspiration and expiration before surgery and ≥6 weeks post-operatively. Following unilateral laser VeC, arytenoid stability improved significantly, with the breathing-related positional variance dropping from a median of 0.158 to 0.039 (p=0.01), particularly in grade D cases; additionally, the operated-side arytenoid showed reduced abduction at maximal opening (0.578 pre-op versus 0.467 post-op, p=0.02). These findings provide the first objective evidence that unilateral laser VeC achieves genuine mechanical stabilisation of the affected arytenoid rather than simply removing obstructive tissue, suggesting the procedure may reduce dynamic airway obstruction during high-speed work, though the small sample size and variable post-operative timing warrant cautious interpretation and merit larger, standardised follow-up studies.
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Practical Takeaways
- •Unilateral laser ventriculocordectomy can improve arytenoid stability in horses with severe RLN, though it does result in slightly reduced abduction of the treated side
- •Grade D (complete collapse) horses appear to benefit more from this procedure than grade C horses, which may help guide surgical candidate selection
- •This procedure should be considered as part of the management strategy for severe RLN, but further research with larger sample sizes and racehorses is needed to confirm efficacy and athletic outcomes
Key Findings
- •Unilateral laser ventriculocordectomy significantly reduced arytenoid instability, with the difference in left-to-right quotient angle ratio between inspiration and expiration decreasing from median 0.158 pre-operatively to 0.039 post-operatively (p=0.01)
- •Left arytenoid abduction was reduced post-operatively (median LRQ 0.467 vs 0.578 pre-operatively, p=0.02)
- •Grade D RLN-affected horses showed significantly greater improvement in arytenoid stability compared with grade C horses (p=0.04)
- •Post-operative assessment conducted at variable timepoints (≥6 weeks post-surgery) with small sample size and no racehorses included