Πέμπτη 6 Φεβρουαρίου 2020

Management of postoperative dysphagia after prosthetic laryngoplasty or arytenoidectomy.

Management of postoperative dysphagia after prosthetic laryngoplasty or arytenoidectomy.:

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Management of postoperative dysphagia after prosthetic laryngoplasty or arytenoidectomy.

Vet Surg. 2020 Feb 04;:

Authors: Luedke LK, Cheetham J, Mohammed HO, Ducharme NG

Abstract

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.

PMID: 32017140 [PubMed - as supplied by publisher]

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