Management of postoperative dysphagia after prosthetic laryngoplasty or arytenoidectomy.

Autor: Luedke LK; Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York., Cheetham J; Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York., Mohammed HO; Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York., Ducharme NG; Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York.
Jazyk: angličtina
Zdroj: Veterinary surgery : VS [Vet Surg] 2020 Apr; Vol. 49 (3), pp. 529-539. Date of Electronic Publication: 2020 Feb 04.
DOI: 10.1111/vsu.13389
Abstrakt: Objective: To evaluate the efficacy of various treatments for dysphagia after laryngeal surgery.
Study Design: Retrospective.
Animals: Horses treated for dysphagia after laryngeal surgery.
Methods: Medical records of horses treated for dysphagia after prosthetic laryngoplasty (PLP) or partial arytenoidectomy (PA) were reviewed. Signalment, prior surgery, preoperative videoendoscopic diagnosis, and surgical treatments were recorded. Short- and long-term follow-up were obtained. Chi-square and logistical regression were performed to correlate independent variables and outcomes.
Results: Forty-four percent of horses with prior PLP and 88% of horses with prior PA had persistent resting dorsal displacement of the soft palate (DDSP). Vocal fold augmentation (VFA) as a single treatment was most commonly performed (n = 22), followed by laryngoplasty removal (LPR; n = 1). Fifteen horses received a combination of treatments: VFA (n = 15), LPR (n = 4), laryngeal tie-forward (LTF; n = 2), and esophageal release (n = 1). Short-term clinical outcomes were reported; 80% of horses treated with VFA (n = 35) had resolution of dysphagia, and 20% were improved. Among the 33 horses available to long-term follow-up, 31 (94%) returned to some level of work, and DDSP during work was reportedly resolved in 23 of 25 horses.
Conclusion: Vocal fold augmentation resulted in resolution of symptoms relating to dysphagia in 81% of horses. Twenty percent of horses treated with LPR had sustained resolution of dysphagia. A combination of LPR, VFA, LTF was performed in 18% of horses.
Clinical Significance: Treatment options directed at altering laryngeal geometry and/or position of the larynx were successful in resolving 86% of dysphagia in horses previously regarded as very difficult to treat.
(© 2020 The American College of Veterinary Surgeons.)
Databáze: MEDLINE
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