Partial arytenoidectomy in the horse using an extralaryngeal approach

An extralaryngeal approach to partial arytenoidectomy in the horse was developed by in vitro experiments on isolated larynges and then on intact equine cadavers. The goals of the approach were to preserve the laryngeal mucosa, eliminate the need for a laryngotomy or tracheotomy, and minimize postoperative complications. The new approach was evaluated in seven horses with normal upper respiratory tracts. Left laryngeal hemiplegia was surgically created, and, after a 30-day convalescence, left partial arytenoidectomy was performed using an extralaryngeal approach. The left-to-right hemilaryngeal ratio was calculated before and after left recurrent laryngeal neurectomy and 60 days after partial arytenoidectomy. Left partial arytenoidectomy was successfully completed in all horses without performing a laryngotomy or tracheotomy. Preservation of the laryngeal mucosa (6/7 horses) and apparent stabilization of the adjacent soft tissue (6/7 horses) was achieved. In one horse, a 1-cm laryngeal mucosal tear healed without complication, and in another some collapse of adjacent soft tissue occurred when a retention suture failed. The mean left-to-right hemilaryngeal ratio was significantly increased compared to horses with left laryngeal hemiplegia, but it remained significantly less than the pre-recurrent laryngeal neurectomy ratio (p < .05). Coughing, aspiration, and airway narrowing were not observed. Partial arytenoidectomy could be reliably performed through an extralaryngeal approach in horses with a normal underlying arytenoid cartilage with preservation of the laryngeal mucosa.