Racing performance following the laryngeal tie-forward procedure: a case-controlled study.
Authors: Cheetham J, Pigott J H, Thorson L M, Mohammed H O, Ducharme N G
Journal: Equine veterinary journal
Summary
# Laryngeal Tie-Forward Surgery: Evidence for Restored Racing Performance Dorsal displacement of the soft palate (DDSP) compromises upper airway stability during exercise, yet the laryngeal tie-forward procedure (LTFP)—an increasingly popular surgical correction—lacked rigorous efficacy data until this case-controlled study of 106 racehorses (36 with definitive DDSP diagnosis, 70 presumptive) treated at Cornell University between 2002 and 2007. Surgically treated horses returned to racing at equivalent rates to matched controls and restored their race earnings to preoperative baseline levels and control-horse equivalents, despite pre-surgical earnings being significantly lower than matched controls. The procedure consistently moved the basihyoid bone dorsally and caudally whilst repositioning the larynx dorsally and rostrally, with more dorsal basihyoid positioning and dorsal-less rostral laryngeal positioning correlating strongly with successful post-operative racing. For equine practitioners managing airway-compromised racehorses, this represents the first controlled evidence that LTFP reliably restores competitive function to the level of unaffected peers. Future investigation into the biomechanical relationship between post-operative laryngohyoid anatomy and nasopharyngeal stability may refine patient selection and optimise surgical outcomes.
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Practical Takeaways
- •LTFP is an effective surgical option for racehorses with DDSP, with treated horses returning to racing at rates equivalent to unaffected controls
- •Post-operative laryngohyoid positioning appears critical to success—closer radiographic monitoring of surgical outcomes may help predict which horses will return to competitive racing
- •Pre-operative earnings decline should not discourage surgery, as performance typically recovers to baseline levels in successfully treated horses
Key Findings
- •Horses undergoing laryngeal tie-forward procedure (LTFP) were equally likely to race post-operatively as matched controls (106 horses, 36 definitive and 70 presumptive DDSP diagnoses)
- •Treated horses had significantly lower race earnings in the race before surgery compared to matched controls, but earnings were restored to preoperative baseline and control levels post-operatively
- •LTFP produced dorsal and caudal movement of the basihyoid bone and dorsal and rostral movement of the larynx
- •More dorsal post-operative basihyoid position and more dorsal, less rostral laryngeal position were associated with increased probability of racing post-operatively