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Surgical Treatment of Iatrogenic Ventral Glottic Stenosis Using a Mucosal Flap Technique

OBJECTIVE: To describe a novel surgical technique for correcting postoperative ventral glottic stenosis (cicatrix or web formation) and the outcome in 2 Thoroughbred racehorses. STUDY DESIGN: Retrospective case report. ANIMALS: Thoroughbreds diagnosed with ventral glottic stenosis (n=2). METHODS: Ho...

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Autores principales: Kane‐Smyth, Justine, Barnett, Timothy P., O'Leary, John Mark, Dixon, Padraic M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5071673/
https://www.ncbi.nlm.nih.gov/pubmed/27013024
http://dx.doi.org/10.1111/vsu.12465
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author Kane‐Smyth, Justine
Barnett, Timothy P.
O'Leary, John Mark
Dixon, Padraic M.
author_facet Kane‐Smyth, Justine
Barnett, Timothy P.
O'Leary, John Mark
Dixon, Padraic M.
author_sort Kane‐Smyth, Justine
collection PubMed
description OBJECTIVE: To describe a novel surgical technique for correcting postoperative ventral glottic stenosis (cicatrix or web formation) and the outcome in 2 Thoroughbred racehorses. STUDY DESIGN: Retrospective case report. ANIMALS: Thoroughbreds diagnosed with ventral glottic stenosis (n=2). METHODS: Horses presenting with iatrogenic ventral glottic stenosis and resultant exercise intolerance and abnormal exercise‐related noise were anesthetized and a midline sagittal skin incision was made over the ventral larynx and between the sternohyoideus muscles overlying the cricothyroid notch. The cricothyroid ligament, attached laryngeal cicatrix, and overlying mucosa were sagittally sectioned at the dorsal aspect of the cicatrix on the left side. The laryngeal mucosa, cicatrix, and underlying cricothyroid ligament immediately rostral and caudal to the cicatrix were sectioned in a medial (axial) direction as far as the right side of the cricothyroid notch. After resection of the majority of the attached cicatrix tissue, the residual mucosal flap (attached to the right side of the larynx) was reflected ventrally and sutured to the attachment of the cricothyroid ligament on the right side of the cricothyroid notch, creating an intact mucosal layer on the right side of the ventral larynx. RESULTS: Both horses had good intralaryngeal wound healing with minimal redevelopment of ventral glottic stenosis at 5 and 9 months postoperatively and were successfully returned to racing with complete absence of abnormal respiratory noise. CONCLUSION: The unique laryngeal anatomy of horses, with a cartilage‐free ventral laryngeal area (cricothyroid notch), allowed the use of this novel surgical technique to successfully treat ventral glottic stenosis.
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spelling pubmed-50716732016-11-02 Surgical Treatment of Iatrogenic Ventral Glottic Stenosis Using a Mucosal Flap Technique Kane‐Smyth, Justine Barnett, Timothy P. O'Leary, John Mark Dixon, Padraic M. Vet Surg Original Articles ‐ Clinical OBJECTIVE: To describe a novel surgical technique for correcting postoperative ventral glottic stenosis (cicatrix or web formation) and the outcome in 2 Thoroughbred racehorses. STUDY DESIGN: Retrospective case report. ANIMALS: Thoroughbreds diagnosed with ventral glottic stenosis (n=2). METHODS: Horses presenting with iatrogenic ventral glottic stenosis and resultant exercise intolerance and abnormal exercise‐related noise were anesthetized and a midline sagittal skin incision was made over the ventral larynx and between the sternohyoideus muscles overlying the cricothyroid notch. The cricothyroid ligament, attached laryngeal cicatrix, and overlying mucosa were sagittally sectioned at the dorsal aspect of the cicatrix on the left side. The laryngeal mucosa, cicatrix, and underlying cricothyroid ligament immediately rostral and caudal to the cicatrix were sectioned in a medial (axial) direction as far as the right side of the cricothyroid notch. After resection of the majority of the attached cicatrix tissue, the residual mucosal flap (attached to the right side of the larynx) was reflected ventrally and sutured to the attachment of the cricothyroid ligament on the right side of the cricothyroid notch, creating an intact mucosal layer on the right side of the ventral larynx. RESULTS: Both horses had good intralaryngeal wound healing with minimal redevelopment of ventral glottic stenosis at 5 and 9 months postoperatively and were successfully returned to racing with complete absence of abnormal respiratory noise. CONCLUSION: The unique laryngeal anatomy of horses, with a cartilage‐free ventral laryngeal area (cricothyroid notch), allowed the use of this novel surgical technique to successfully treat ventral glottic stenosis. John Wiley and Sons Inc. 2016-03-25 2016-05 /pmc/articles/PMC5071673/ /pubmed/27013024 http://dx.doi.org/10.1111/vsu.12465 Text en © 2016 The Authors. Veterinary Surgery published by Wiley Periodicals, Inc., on behalf of The American College of Veterinary Surgeons. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles ‐ Clinical
Kane‐Smyth, Justine
Barnett, Timothy P.
O'Leary, John Mark
Dixon, Padraic M.
Surgical Treatment of Iatrogenic Ventral Glottic Stenosis Using a Mucosal Flap Technique
title Surgical Treatment of Iatrogenic Ventral Glottic Stenosis Using a Mucosal Flap Technique
title_full Surgical Treatment of Iatrogenic Ventral Glottic Stenosis Using a Mucosal Flap Technique
title_fullStr Surgical Treatment of Iatrogenic Ventral Glottic Stenosis Using a Mucosal Flap Technique
title_full_unstemmed Surgical Treatment of Iatrogenic Ventral Glottic Stenosis Using a Mucosal Flap Technique
title_short Surgical Treatment of Iatrogenic Ventral Glottic Stenosis Using a Mucosal Flap Technique
title_sort surgical treatment of iatrogenic ventral glottic stenosis using a mucosal flap technique
topic Original Articles ‐ Clinical
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5071673/
https://www.ncbi.nlm.nih.gov/pubmed/27013024
http://dx.doi.org/10.1111/vsu.12465
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