Unilateral laser ventriculocordectomy results in increased arytenoid
stability in horses with severe left sided recurrent laryngeal
neuropathy.
Abstract
Background: There is no objective information reporting the
effect of unilateral laser ventriculocordectomy (VeC) on arytenoid
abduction or stability. Objectives: To evaluate arytenoid
stability and abduction in horses with severe recurrent laryngeal
neuropathy (RLN) before and after unilateral laser VeC. Study
design: Prospective study in clinically affected client-owned horses.
Methods: Sample size calculations indicated ≥7 horses were
required. Horses with grade C or D exercising laryngeal function that
underwent unilateral laser VeC were included. Exercising endoscopy was
performed before and ≥6 weeks after left-sided laser VeC. Arytenoid
stability at maximal exercise was calculated by measuring the
left-to-right quotient angle ratio (LRQ) of the corniculate processes at
the points of maximal arytenoid abduction (expiration) and maximal
arytenoid collapse (inspiration). For each horse, means of measurements
obtained for four breaths pre- and post-operatively were used for
statistical analysis. Results: Eight horses were included: 5
grade C and 3 grade D laryngeal function. The difference in LRQ between
inspiration and expiration was lower post-operatively (median 0.039;
interquartile range [IQR] 0.032-0.047) compared to pre-operatively
(median 0.158; IQR 0.083-0.249; p=0.01) confirming the left arytenoid
was more stable following unilateral laser VeC. The degree of
improvement was significantly greater for grade D horses compared to
grade C horses (p=0.04). The LRQ measured on maximal abduction was also
lower post-operatively (median 0.467; IQR 0.444-0.506) compared to
pre-operatively (median 0.578; IQR 0.554-0.655; p=0.02) indicating the
left arytenoid was less abducted following surgery. Main study
limitations: The sample size was small, no racehorses were included and
post-operative assessment was conducted at a variable time after
surgery. Conclusion: Unilateral laser VeC in grade C and D
RLN-affected horses results in slightly reduced left arytenoid abduction
but increased arytenoid stability.