41635Ross University, Basseterre, Saint Kitts and Nevis.
43317Cornell University, Ithaca, NY, USA.
Vet Pathol. 2021 Jan;58(1):91-102. doi: 10.1177/0300985820967452. Epub 2020 Nov 18.
Equine arytenoid chondritis causes airway obstruction and abnormal upper airway noise due to a space-occupying lesion(s) and decreased abduction. Our objective was to compare clinical scores and ultrasonographic findings with gross and microscopic lesions of naturally occurring arytenoid chondritis, in order to guide surgical treatment. Seventeen naturally affected horses with advanced/severe chronic arytenoid chondritis and 4 control arytenoid cartilages were evaluated after partial arytenoidectomy. Cartilages were sectioned caudal to the corniculate process and the body of each arytenoid was measured. We assessed total gross area (TA), percentage of viable cartilage (VC), percentage of viable cartilage on the lateral wall, and medial expansion. Retrospectively, the gross lesions were used to suggest 2 preferred surgical management (SM) groups: those requiring partial arytenoidectomy and those amendable to focal medial resection (a conservative SM). TA of horses with arytenoid chondritis was significantly larger than controls ( = .005), due to a layered lesion composed of cavitation, granulation tissue, fibrosis, inflammation, hemorrhage, and edema, with relatively equal medial and lateral expansion that distorted the geometry of the affected cartilage. The increased TA paralleled the presence of immature cartilage with disorganized primitive mesenchymal cells. TA and SM were positively correlated ( = .01). All cases showed varying degrees of cartilage degeneration or necrosis, more severe medially; those appearing amenable to focal medial resection arytenoid group had significantly more viable cartilage on the lateral wall ( = .02). The gross and histopathologic findings suggest a new surgical approach-focal medial resection-that may save the lateral wall of the arytenoid.
马的杓状软骨软骨炎由于占位性病变和外展减少导致气道阻塞和异常上气道噪音。我们的目的是比较临床评分和超声检查结果与自然发生的杓状软骨软骨炎的大体和微观病变，以指导手术治疗。17 匹患有晚期/严重慢性杓状软骨软骨炎的自然发病马和 4 个对照杓状软骨在部分杓状软骨切除术之后进行了评估。软骨在角状突后和杓状软骨体的尾部进行切片，并对每个杓状软骨进行测量。我们评估了总大体面积（TA）、有活力软骨的百分比（VC）、外侧壁有活力软骨的百分比和内侧扩张。回顾性地，大体病变被用来建议 2 种首选的手术管理（SM）组：需要部分杓状软骨切除术和那些适合于焦点内侧切除术的（保守的 SM）。患有杓状软骨炎的马的 TA 明显大于对照组（=.005），这是由于分层病变，由空洞、肉芽组织、纤维化、炎症、出血和水肿组成，内侧和外侧扩张相对相等，从而扭曲了受影响软骨的几何形状。增加的 TA 与具有无序原始间充质细胞的不成熟软骨平行存在。TA 和 SM 呈正相关（=.01）。所有病例均显示出不同程度的软骨退化或坏死，内侧更为严重；那些似乎适合焦点内侧切除术的杓状软骨组，外侧壁有活力软骨明显更多（=.02）。大体和组织病理学发现提示了一种新的手术方法——焦点内侧切除术，该方法可能会保留杓状软骨的外侧壁。
