34th Annual Scientific Meeting proceedings

Objectives:

To compare outcomes between laryngoplasty and Dynamic Neuroprosthesis (DNP), both using corkscrew implant, as a treatment for Recurrent Laryngeal Neuropathy (RLN) in horses. Secondly, to assess the complication rate associated with a corkscrew implant.

Methods:

Records from horses undergoing laryngoplasty or DNP (laryngoplasty combined with nerve grafting onto the cricoarytenoideus-dorsalis muscle) between 01/2020 and 12/2023 were analysed. Signalment, arytenoid abduction grade at rest and during exercise, short- and long-term surgical complications, clinical symptom resolution, and return to sport were studied. Long-term follow-up and client satisfaction were obtained through telephone interviews.

Results:

Out of 367 included horses, 98.5% underwent standing surgery. Laryngoplasty was mostly performed in severe cases (70% in Grade 4), while DNP cases were evenly distributed among Grades 3.2, and 3.3 and 4 (30% each). High satisfaction levels were reported for both techniques (as follow, DNP: 4.2/5 / laryngoplasty: 4.4/5), with most of horses returning to sports within a year (87% / 88%), with no significant differences between the techniques. Complications included short-term cough (21% / 31%) and seroma formation (35% / 27%), mostly resolving spontaneously. Long-term complications were minimal. Pull out and chondritis were observed respectively in 0,5%  and 1,6% of surgery involving a corkscrew. Prosthesis relaxation which needed a repeat laryngoplasty occurred in 5,2% of cases. In contrast 3,1% of horses needed surgery to relax one or several sutures.

Conclusions:

The hybrid DNP approach emerges as an alternative for RLN treatment. Both DNP and laryngoplasty enable most horses to return to sports with relatively low complication rates. The use of corkscrew implants does not appear to introduce additional complications compared to traditional laryngoplasties.