Grzeskowiak Remigiusz M, Schumacher James, Mulon Pierre-Yves, Steiner Richard C, Cassone Lynne, Anderson David E
Department of Large Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, Knoxville, TN, United States.
Veterinary Diagnostic Laboratory, College of Agriculture, Food and Environment, The University of Kentucky, Lexington, KY, United States.
Front Vet Sci. 2020 Mar 12;7:139. doi: 10.3389/fvets.2020.00139. eCollection 2020.
Rostral laryngeal advancement, also known as laryngeal tie-forward, is used to treat horses for intermittent dorsal displacement of the soft palate and has a morbidity rate of about 6%. We hypothesized that a novel laryngeal clamp would prevent morbidity associated with the sutures tearing through the thyroid cartilage. Larynges ( = 35 horses) were used for testing. For uniaxial testing, 15 equine larynges were tested in one of three laryngeal tie-forward constructs [standard laryngeal tie-forward; modified laryngeal tie-forward using a suture-button; and modified laryngeal tie-forward using a laryngeal clamp]. For biaxial testing, 20 larynges were tested in one of two treatment groups: laryngeal tie-forward and laryngeal tie-forward using a laryngeal clamp. Constructs were tested in single cycle-to-failure. Statistical analyses were performed using ANOVA for uniaxial testing and -tests for biaxial testing. The laryngeal tie-forward using a laryngeal clamp construct was superior to laryngeal tie-forward and laryngeal tie-forward using a suture-button constructs in resistance to pullout in uniaxial testing. The laryngeal tie-forward using a laryngeal clamp presented a significantly different method of failure than the standard laryngeal tie-forward in the biaxial testing. Failure modes for each construct were primarily by suture failure at the clamp (laryngeal tie-forward using a laryngeal clamp), suture pullout through the thyroid cartilage, or, less commonly, tearing of the cricothyroid ligament (laryngeal tie-forward). In uniaxial testing, the laryngeal tie-forward using a laryngeal clamp failed most commonly due to tearing of the cricothyroid ligament, whereas the standard laryngeal tie-forward and the laryngeal tie-forward using a suture-button failed due to the tearing of the cartilage. The laryngeal clamps provided greater stiffness, load at yield, and tensile stress at yield than did the standard construct. Laryngeal clamps may offer an alternative to standard methods of anchoring the thyroid cartilage when performing the laryngeal tie-forward procedure. Further testing and clinical trials are needed to elucidate the utility of the laryngeal tie-forward using a laryngeal clamp.
喉向前移位术，也称为喉前固定术，用于治疗马匹软腭间歇性背侧移位，发病率约为6%。我们假设一种新型喉夹可以预防与缝线穿透甲状软骨相关的发病情况。使用了35匹马的喉进行测试。对于单轴测试，15个马喉在三种喉前固定结构之一中进行测试[标准喉前固定术；使用缝线纽扣的改良喉前固定术；以及使用喉夹的改良喉前固定术]。对于双轴测试，20个喉在两个治疗组之一中进行测试：喉前固定术和使用喉夹的喉前固定术。结构在单次失效循环中进行测试。单轴测试使用方差分析进行统计分析，双轴测试使用t检验进行统计分析。在单轴测试中，使用喉夹的喉前固定结构在抗拔出力方面优于喉前固定术和使用缝线纽扣的喉前固定结构。在双轴测试中，使用喉夹的喉前固定术与标准喉前固定术的失效方式有显著差异。每种结构的失效模式主要是喉夹处的缝线失效（使用喉夹的喉前固定术）、缝线从甲状软骨中拔出，或者较少见的环甲韧带撕裂（喉前固定术）。在单轴测试中，使用喉夹的喉前固定术最常见的失效原因是环甲韧带撕裂，而标准喉前固定术和使用缝线纽扣的喉前固定术则因软骨撕裂而失效。与标准结构相比，喉夹提供了更大的刚度、屈服载荷和屈服拉伸应力。在进行喉前固定手术时，喉夹可能为固定甲状软骨的标准方法提供一种替代方案。需要进一步的测试和临床试验来阐明使用喉夹的喉前固定术的实用性。
