Rossignol Fabrice, Ouachée Emilie, Boening Karl Josef
Clinique de Grosbois, Boissy Saint Léger, France.
Vet Surg. 2012 Aug;41(6):685-8. doi: 10.1111/j.1532-950X.2012.01001.x. Epub 2012 Jul 23.
To describe a modified laryngeal tie-forward procedure (LTFP) using metallic implants.
Retrospective case series.
Twenty-seven horses (including 24 race horses) with dorsal displacement of the soft palate (DDSP) or palatal instability (PI) diagnosed using high-speed treadmill endoscopy (n = 15), history and resting examination (n = 8), or dynamic endoscopy over ground (n = 4).
All horses underwent the modified LTFP. Modifications of the surgical procedure consisted in the use of 3 metallic stents called Suture Button(TM) through which the sutures are threaded and in a tying technique that involved a single knot connecting left and right suture loops (versus tying each separately). Lateral radiographs were taken 24 hours after surgery. Follow-up was obtained by telephone communication with trainers or owners.
Surgery was performed without complications on all horses. The 3 metallic buttons were clearly visible on the postoperative radiographic examination. No evidence of suture breakage was observed 24 hours postoperatively based on radiographs.
In other aspects, this technique is not very different from that originally described by Ducharme et al; it is an innovation that could offer some advantages to the surgeons and increase suture resistance to pullout from the thyroid cartilage. Our technique was used without complication in a small group of horses and return to performance may be similar to the original technique.
描述一种使用金属植入物的改良喉前牵引术(LTFP)。
回顾性病例系列。
27匹马(包括24匹赛马),通过高速跑步机内窥镜检查诊断为软腭背侧移位(DDSP)或腭不稳定(PI)(n = 15),通过病史和静息检查诊断(n = 8),或通过地面动态内窥镜检查诊断(n = 4)。
所有马匹均接受改良LTFP。手术方法的改进包括使用3个称为缝合纽扣(Suture Button™)的金属支架,缝线穿过这些支架,以及采用一种打结技术,该技术涉及一个连接左右缝线环的单结(而不是分别打结)。术后24小时拍摄侧位X线片。通过与驯马师或马主电话沟通进行随访。
所有马匹手术均无并发症。术后X线检查中3个金属纽扣清晰可见。术后24小时的X线片显示没有缝线断裂的迹象。
在其他方面,该技术与Ducharme等人最初描述的技术没有太大差异;这是一项创新,可为外科医生提供一些优势,并增加缝线对从甲状软骨拔出的抵抗力。我们的技术在一小群马匹中使用时没有并发症,恢复比赛状态可能与原始技术相似。