O'Neill H D, Ballegeer E A, De Feijter-Rupp H L, Stick J A, Derksen F J, Robinson N E
Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, USA.
Equine Vet J. 2014 Mar;46(2):244-8. doi: 10.1111/evj.12105. Epub 2013 Aug 30.
Current diagnosis of recurrent laryngeal neuropathy (RLN) depends upon disease recognition in the clinically affected horse. Biopsy of the intrinsic laryngeal muscles may provide a method to identify the changes in fibre-type composition that occur in RLN before clinical signs become apparent.
To develop an ultrasound-guided biopsy technique of the left cricoarytenoideus lateralis muscle (CALM) and evaluate its efficacy and safety in vivo.
A longitudinal descriptive study.
Six standing horses underwent ultrasound-guided biopsy of the left CALM. Frozen muscle cores were obtained with a breast biopsy tool. Serial endoscopic, ultrasonographic and physical examinations before and for 8 weeks after the biopsy were assessed for iatrogenic trauma. Histologies of representative muscle core cross-sections were analysed for the total number of muscle fibres obtained with each biopsy.
There were no immediate complications of the procedure and the left CALM was harvested in all instances. Biopsy samples had an average weight of 0.043 g (range = 0.023-0.077 g) and contained 3418 fibres in cross-section (range = 711-7143). Laryngeal endoscopic grade did not change significantly between prebiopsy and the end of the 8 week follow-up. The left CALM had significantly greater echogenicity than the right throughout the study (P<0.001), but there was no difference between the prebiopsy CALM echogenicity and that at completion of the study.
Ultrasound-guided biopsy of the left CALM is safe and well tolerated, providing a minimally invasive method to obtain muscle from healthy horses. This new technique may be applicable in research and clinical settings.
目前喉返神经(RLN)损伤的诊断依赖于对临床出现症状马匹的疾病识别。喉内肌活检可能提供一种方法,以识别在临床症状出现之前喉返神经损伤时发生的肌纤维类型组成变化。
开发一种左侧环杓侧肌(CALM)的超声引导下活检技术,并评估其在体内的有效性和安全性。
一项纵向描述性研究。
对6匹站立的马匹进行左侧CALM的超声引导下活检。使用乳腺活检工具获取冷冻肌芯。在活检前及活检后8周内,连续进行内镜检查、超声检查和体格检查,评估医源性创伤情况。对代表性肌芯横截面的组织学进行分析,以确定每次活检获得的肌纤维总数。
该操作无即时并发症,所有病例均成功获取左侧CALM。活检样本平均重量为0.043 g(范围 = 0.023 - 0.077 g),横截面包含3418根肌纤维(范围 = 711 - 7143)。活检前与8周随访结束时,喉内镜分级无显著变化。在整个研究过程中,左侧CALM的回声明显强于右侧(P<0.001),但活检前CALM的回声与研究结束时无差异。
左侧CALM的超声引导下活检安全且耐受性良好,为从健康马匹获取肌肉提供了一种微创方法。这项新技术可能适用于研究和临床环境。