Tetens J, Derksen F J, Stick J A, Lloyd J W, Robinson N E
Department of Large Animal Clinical Sciences, Michigan State University, East Lansing 48824-1314, USA.
Am J Vet Res. 1996 Nov;57(11):1668-73.
To evaluate the efficacy of prosthetic laryngoplasty with and without bilateral ventriculocordectomy for treatment of experimentally induced left laryngeal hemiplegia (LLH).
15 adult Standardbreds.
Horses were allotted to 3 equal groups. Sham operation (group 1), prosthetic laryngoplasty (group 2), or prosthetic laryngoplasty with bilateral ventriculocordectomy (group 3) was performed after induction of LLH. Upper airway function testing was performed prior to left recurrent laryngeal neurectomy (LRLN), 14 days after LRLN, and 60 and 180 days after surgical treatment. Measurements were obtained at rest and at treadmill speeds corresponding to 75 and 100% of maximal heart rate. Videoendoscopy was performed at rest and during exercise in all horses prior to LRLN and 60 and 180 days after surgical treatment. Upper airway endoscopy was performed immediately after LRLN to document induction of grade-IV LLH. Also, horses in group 3 were endoscopically examined at 7, 14, 21, 28, and 120 days after surgical treatment to evaluate healing of the ventriculocordectomy sites.
When horses were at rest, significant differences were not apparent between groups at any period or between periods for any measured variable. LRLN induced airway obstruction in all horses during exercise. In sham-operated horses, this obstruction was unaffected by time. In contrast, 60 and 180 days after surgical treatment, inspiratory flow limitations induced by LRLN were reversed in horses of groups 2 and 3. There were no significant differences between the 2 treatment groups. Endoscopy revealed the left arytenoid cartilage abducted beyond the intermediate position, but not touching the pharyngeal wall in all horses with a laryngeal prosthesis. After surgical treatment, 4 group-2 horses had filling of both ventricles with air during exercise. There was moderate to marked swelling of the ventriculocordectomy sites immediately after surgery, and this swelling resolved by 7 days after surgery. The ventriculocordectomy sites looked best at 14 and 180 days.
60 and 180 days after prosthetic laryngoplasty, upper airway function returned to pre-LRLN values in horses with experimentally induced LLH exercising at 100% of maximal heart rate. Combining ventriculocordectomy with prosthetic laryngoplasty does not further improve upper airway function in these horses.
评估在有或没有双侧室带声带切除术的情况下，人工喉成形术治疗实验性诱导的左侧喉偏瘫（LLH）的疗效。
15匹成年标准赛马。
将马分为3个相等的组。在诱导LLH后，分别进行假手术（第1组）、人工喉成形术（第2组）或人工喉成形术联合双侧室带声带切除术（第3组）。在左侧喉返神经切除术（LRLN）前、LRLN后14天以及手术治疗后60天和180天进行上呼吸道功能测试。在静息状态以及对应最大心率75%和100%的跑步机速度下进行测量。在LRLN前以及手术治疗后60天和180天，对所有马匹在静息和运动期间进行视频内镜检查。在LRLN后立即进行上呼吸道内镜检查，以记录IV级LLH的诱导情况。此外，在手术治疗后7天、14天、21天、28天和120天对第3组的马匹进行内镜检查，以评估室带声带切除部位的愈合情况。
当马处于静息状态时，在任何时期或任何测量变量的不同时期之间，各组之间均未发现明显差异。LRLN在所有马匹运动期间均导致气道阻塞。在假手术的马匹中，这种阻塞不受时间影响。相比之下，在手术治疗后60天和180天，第2组和第3组马匹中由LRLN诱导的吸气流量受限情况得到了改善。两个治疗组之间没有显著差异。内镜检查显示，所有佩戴喉假体的马匹中，左侧杓状软骨外展超过中间位置，但未接触咽壁。手术治疗后，第2组有4匹马在运动期间两个心室均有气体充盈。手术后室带声带切除部位立即出现中度至明显肿胀，这种肿胀在术后7天消退。室带声带切除部位在14天和180天时看起来最佳。
在人工喉成形术后60天和180天，实验性诱导LLH且以最大心率100%运动的马匹的上呼吸道功能恢复到LRLN前的值。在这些马匹中，将室带声带切除术与人工喉成形术相结合并不能进一步改善上呼吸道功能。
