Barakzai S Z, Wells J, Parkin T D H, Cramp P
Equine Surgical Referrals, Clapham, Sussex, UK.
Department of Music, University of York, Yorkshire, UK.
Equine Vet J. 2019 Mar;51(2):185-191. doi: 10.1111/evj.12993. Epub 2018 Aug 9.
Unilateral ventriculocordectomy (VeC) is frequently performed, yet objective studies in horses with naturally occurring recurrent laryngeal neuropathy (RLN) are few.
To evaluate respiratory noise and exercising overground endoscopy in horses with grade B and C laryngeal function, before and after unilateral laser VeC.
Prospective study in clinically affected client-owned horses.
Exercising endoscopy was performed and concurrent respiratory noise was recorded. A left-sided laser VeC was performed under standing sedation. Owners were asked to present the horse for re-examination 6-8 weeks post-operatively when exercising endoscopy and sound recordings were repeated. Exercising endoscopic findings were recorded, including the degree of arytenoid stability. Quantitative measurement of left-to-right quotient angle ratio (LRQ) and rima glottidis area ratio (RGA) were performed pre- and post-operatively. Sound analysis was performed, and measurements of the energy change in F1, F2 and F3 formants between pre- and post-operative recordings were made and statistically analysed.
Three grade B and seven grade C horses were included; 6/7grade C horses preoperatively had bilateral vocal fold collapse (VFC) and 5/7 had mild right-sided medial deviation of the ary-epiglottic fold (MDAF). Right VFC and MDAF was still present in these horses post-operatively; grade B horses had no other endoscopic dynamic abnormalities post-operatively. Sound analysis showed significant reduction in energy in formant F2 (P = 0.05) after surgery.
The study sample size was small and multiple dynamic abnormalities made sound analysis challenging.
RLN-affected horses have reduction in sound levels in F2 after unilateral laser VeC. Continuing noise may be caused by other ongoing forms of dynamic obstruction in grade C horses. Unilateral VeC is useful for grade B horses based on endoscopic images. In grade C horses, bilateral VeC, right ary-epiglottic fold resection ± laryngoplasty might be a better option than unilateral VeC alone. The Summary is available in Portuguese - see Supporting Information.
单侧声带切除术（VeC）经常进行，但针对自然发生喉返神经麻痹（RLN）马匹的客观研究较少。
评估B级和C级喉功能马匹在单侧激光VeC术前和术后的呼吸噪音及地面运动内镜检查情况。
对临床患病的客户拥有马匹进行前瞻性研究。
进行运动内镜检查并同步记录呼吸噪音。在站立镇静状态下实施左侧激光VeC。要求主人在术后6 - 8周牵马复诊，再次进行运动内镜检查和声音记录。记录运动内镜检查结果，包括杓状软骨稳定性程度。术前和术后对左右商角比（LRQ）和声门裂面积比（RGA）进行定量测量。进行声音分析，测量术前和术后录音中F1、F2和F3共振峰的能量变化并进行统计分析。
纳入3匹B级和7匹C级马匹；7匹C级马匹中有6匹术前存在双侧声带塌陷（VFC），7匹中有5匹存在右侧杓会厌襞轻度内侧偏移（MDAF）。这些马匹术后右侧VFC和MDAF仍然存在；B级马匹术后无其他内镜动态异常。声音分析显示术后共振峰F2能量显著降低（P = 0.05）。
研究样本量小，多种动态异常使声音分析具有挑战性。
单侧激光VeC术后，受RLN影响的马匹F2声音水平降低。C级马匹持续存在的噪音可能由其他持续存在的动态阻塞形式引起。基于内镜图像，单侧VeC对B级马匹有用。对于C级马匹，双侧VeC、右侧杓会厌襞切除术±喉成形术可能比单纯单侧VeC是更好的选择。总结内容有葡萄牙语版本 - 见支持信息。
