Hay W P, Tulleners E P, Ducharme N G
Department of Clinical Studies, University of Pennsylvania, School of Veterinary Medicine, Kennett Square.
Vet Surg. 1993 Jan-Feb;22(1):50-6. doi: 10.1111/j.1532-950x.1993.tb00368.x.
An extralaryngeal approach to partial arytenoidectomy in the horse was developed by in vitro experiments on isolated larynges and then on intact equine cadavers. The goals of the approach were to preserve the laryngeal mucosa, eliminate the need for a laryngotomy or tracheotomy, and minimize postoperative complications. The new approach was evaluated in seven horses with normal upper respiratory tracts. Left laryngeal hemiplegia was surgically created, and, after a 30-day convalescence, left partial arytenoidectomy was performed using an extralaryngeal approach. The left-to-right hemilaryngeal ratio was calculated before and after left recurrent laryngeal neurectomy and 60 days after partial arytenoidectomy. Left partial arytenoidectomy was successfully completed in all horses without performing a laryngotomy or tracheotomy. Preservation of the laryngeal mucosa (6/7 horses) and apparent stabilization of the adjacent soft tissue (6/7 horses) was achieved. In one horse, a 1-cm laryngeal mucosal tear healed without complication, and in another some collapse of adjacent soft tissue occurred when a retention suture failed. The mean left-to-right hemilaryngeal ratio was significantly increased compared to horses with left laryngeal hemiplegia, but it remained significantly less than the pre-recurrent laryngeal neurectomy ratio (p < .05). Coughing, aspiration, and airway narrowing were not observed. Partial arytenoidectomy could be reliably performed through an extralaryngeal approach in horses with a normal underlying arytenoid cartilage with preservation of the laryngeal mucosa.
通过对离体喉部进行体外实验，然后在完整的马尸体上进行实验，开发出一种马的喉外部分杓状软骨切除术方法。该方法的目标是保留喉黏膜，避免进行喉切开术或气管切开术，并将术后并发症降至最低。在7匹上呼吸道正常的马身上对这种新方法进行了评估。通过手术造成左侧喉偏瘫，在30天的恢复期后，采用喉外方法进行左侧部分杓状软骨切除术。在左侧喉返神经切除术前、后以及部分杓状软骨切除术后60天计算左右半喉比例。所有马匹均成功完成左侧部分杓状软骨切除术，未进行喉切开术或气管切开术。实现了喉黏膜的保留（6/7匹马）以及相邻软组织的明显稳定（6/7匹马）。在一匹马中，一处1厘米的喉黏膜撕裂无并发症愈合，在另一匹马中，一根固定缝线失效时相邻软组织出现了一些塌陷。与左侧喉偏瘫的马匹相比，平均左右半喉比例显著增加，但仍显著低于喉返神经切除术前的比例（p <.05）。未观察到咳嗽、误吸和气道狭窄情况。对于杓状软骨正常且能保留喉黏膜的马匹，部分杓状软骨切除术可通过喉外方法可靠地进行。
