Robinson P, Williams K J, Sullins K E, Arnoczky S P, Stick J A, Robinson N E, de Feijter-Rupp H, Derksen F J
Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, Michigan 48824, USA.
Equine Vet J. 2007 May;39(3):222-5. doi: 10.2746/042516407x175198.
Trans-endoscopic laser surgery, such as unilateral laser-assisted ventriculocordectomy (LVC), has gained popularity in the treatment of RLN because a laryngotomy incision or general anaesthesia are not required. However, removal of the vocal fold and ventricle takes considerable laser energy and could cause collateral tissue damage, including injury to the adjacent laryngeal cartilages.
To document the histological effects of laser surgery on laryngeal tissues in horses that have undergone LVC for the treatment of laryngeal hemiplegia (LH).
Six horses were used: 4 with experimentally induced LH that had subsequently undergone LVC 6 months prior to euthanasia; and, 2 horses were used as controls. One of the control horses with naturally occurring LH was used to study the effect of neuropathy alone, whereas the other was subjected to euthanasia immediately following LVC to evaluate the acute effect of laser surgery. Using a band saw, each larynx was sectioned transversely at 5 mm intervals and evaluated histologically.
Acutely, LVC caused thermal damage to adjacent soft tissues but did not affect the histology of the laryngeal cartilages. Six months after LVC, laryngeal cartilages were histologically normal and there was squamous metaplasia of the repaired laryngeal mucosa, resulting in restitution of the mucosal integrity.
Using a diode laser in contact fashion at 20 W, LVC can be used to remove the laryngeal vocal fold and ventricle without causing laryngeal cartilage damage.
Laryngeal chondritis is an unlikely consequence of LVC.
经内镜激光手术,如单侧激光辅助心室索切除术(LVC),在喉返神经(RLN)治疗中越来越受欢迎,因为无需进行喉切开术切口或全身麻醉。然而,切除声带和心室需要相当多的激光能量,并且可能导致附带组织损伤,包括对相邻喉软骨的损伤。
记录激光手术对因喉偏瘫(LH)接受LVC治疗的马匹喉组织的组织学影响。
使用了6匹马:4匹患有实验性诱导的LH,在安乐死6个月前接受了LVC;另外2匹马作为对照。其中一匹患有自然发生的LH的对照马用于单独研究神经病变的影响,而另一匹在LVC后立即进行安乐死以评估激光手术的急性影响。使用带锯,将每个喉部以5毫米的间隔横向切片并进行组织学评估。
急性情况下,LVC对相邻软组织造成热损伤,但不影响喉软骨的组织学。LVC后6个月,喉软骨组织学正常,修复后的喉黏膜出现鳞状化生,导致黏膜完整性恢复。
以20瓦的接触方式使用二极管激光,LVC可用于切除喉声带和心室而不引起喉软骨损伤。
LVC不太可能导致喉软骨炎。