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Management of postoperative dysphagia after prosthetic laryngoplasty or arytenoidectomy.
Vet Surg. 2020 Apr; 49(3):529-539.VS

Abstract

OBJECTIVE

To evaluate the efficacy of various treatments for dysphagia after laryngeal surgery.

STUDY DESIGN

Retrospective.

ANIMALS

Horses treated for dysphagia after laryngeal surgery.

METHODS

Medical records of horses treated for dysphagia after prosthetic laryngoplasty (PLP) or partial arytenoidectomy (PA) were reviewed. Signalment, prior surgery, preoperative videoendoscopic diagnosis, and surgical treatments were recorded. Short- and long-term follow-up were obtained. Chi-square and logistical regression were performed to correlate independent variables and outcomes.

RESULTS

Forty-four percent of horses with prior PLP and 88% of horses with prior PA had persistent resting dorsal displacement of the soft palate (DDSP). Vocal fold augmentation (VFA) as a single treatment was most commonly performed (n = 22), followed by laryngoplasty removal (LPR; n = 1). Fifteen horses received a combination of treatments: VFA (n = 15), LPR (n = 4), laryngeal tie-forward (LTF; n = 2), and esophageal release (n = 1). Short-term clinical outcomes were reported; 80% of horses treated with VFA (n = 35) had resolution of dysphagia, and 20% were improved. Among the 33 horses available to long-term follow-up, 31 (94%) returned to some level of work, and DDSP during work was reportedly resolved in 23 of 25 horses.

CONCLUSION

Vocal fold augmentation resulted in resolution of symptoms relating to dysphagia in 81% of horses. Twenty percent of horses treated with LPR had sustained resolution of dysphagia. A combination of LPR, VFA, LTF was performed in 18% of horses.

CLINICAL SIGNIFICANCE

Treatment options directed at altering laryngeal geometry and/or position of the larynx were successful in resolving 86% of dysphagia in horses previously regarded as very difficult to treat.

Authors+Show Affiliations

Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York.Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York.Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York.Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32017140

Citation

Luedke, Lauren K., et al. "Management of Postoperative Dysphagia After Prosthetic Laryngoplasty or Arytenoidectomy." Veterinary Surgery : VS, vol. 49, no. 3, 2020, pp. 529-539.
Luedke LK, Cheetham J, Mohammed HO, et al. Management of postoperative dysphagia after prosthetic laryngoplasty or arytenoidectomy. Vet Surg. 2020;49(3):529-539.
Luedke, L. K., Cheetham, J., Mohammed, H. O., & Ducharme, N. G. (2020). Management of postoperative dysphagia after prosthetic laryngoplasty or arytenoidectomy. Veterinary Surgery : VS, 49(3), 529-539. https://doi.org/10.1111/vsu.13389
Luedke LK, et al. Management of Postoperative Dysphagia After Prosthetic Laryngoplasty or Arytenoidectomy. Vet Surg. 2020;49(3):529-539. PubMed PMID: 32017140.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of postoperative dysphagia after prosthetic laryngoplasty or arytenoidectomy. AU - Luedke,Lauren K, AU - Cheetham,Jonathan, AU - Mohammed,Hussni O, AU - Ducharme,Norm G, Y1 - 2020/02/04/ PY - 2019/05/20/received PY - 2019/11/13/revised PY - 2020/01/09/accepted PY - 2020/2/6/pubmed PY - 2020/2/6/medline PY - 2020/2/5/entrez SP - 529 EP - 539 JF - Veterinary surgery : VS JO - Vet Surg VL - 49 IS - 3 N2 - OBJECTIVE: To evaluate the efficacy of various treatments for dysphagia after laryngeal surgery. STUDY DESIGN: Retrospective. ANIMALS: Horses treated for dysphagia after laryngeal surgery. METHODS: Medical records of horses treated for dysphagia after prosthetic laryngoplasty (PLP) or partial arytenoidectomy (PA) were reviewed. Signalment, prior surgery, preoperative videoendoscopic diagnosis, and surgical treatments were recorded. Short- and long-term follow-up were obtained. Chi-square and logistical regression were performed to correlate independent variables and outcomes. RESULTS: Forty-four percent of horses with prior PLP and 88% of horses with prior PA had persistent resting dorsal displacement of the soft palate (DDSP). Vocal fold augmentation (VFA) as a single treatment was most commonly performed (n = 22), followed by laryngoplasty removal (LPR; n = 1). Fifteen horses received a combination of treatments: VFA (n = 15), LPR (n = 4), laryngeal tie-forward (LTF; n = 2), and esophageal release (n = 1). Short-term clinical outcomes were reported; 80% of horses treated with VFA (n = 35) had resolution of dysphagia, and 20% were improved. Among the 33 horses available to long-term follow-up, 31 (94%) returned to some level of work, and DDSP during work was reportedly resolved in 23 of 25 horses. CONCLUSION: Vocal fold augmentation resulted in resolution of symptoms relating to dysphagia in 81% of horses. Twenty percent of horses treated with LPR had sustained resolution of dysphagia. A combination of LPR, VFA, LTF was performed in 18% of horses. CLINICAL SIGNIFICANCE: Treatment options directed at altering laryngeal geometry and/or position of the larynx were successful in resolving 86% of dysphagia in horses previously regarded as very difficult to treat. SN - 1532-950X UR - https://www.unboundmedicine.com/medline/citation/32017140/Management_of_postoperative_dysphagia_after_prosthetic_laryngoplasty_or_arytenoidectomy L2 - https://doi.org/10.1111/vsu.13389 DB - PRIME DP - Unbound Medicine ER -
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