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1.
Temporary right recurrent laryngeal neuropathy in a horse associated with a left prosthetic laryngoplasty procedure 下载免费PDF全文
Right recurrent laryngeal neuropathy (RLN) is an uncommon, acquired disease for which the aetiology can frequently be diagnosed. Numerous aetiologies have been proposed for right‐sided RLN which comprises 2% of all cases of RLN. In this report we discuss the clinical course, treatment and outcome following right‐sided laryngeal paralysis as a complication of left‐sided prosthetic laryngoplasty in a horse. To the authors' knowledge, this is the first report of such a surgical complication. 相似文献
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Recurrent laryngeal neuropathy (RLN, laryngeal hemiplegia, laryngeal paralysis, ‘roaring’) is common in the equine industry with a prevalence ranging from 2.6–11% in light breeds ( Raphel 1982 ; Lane 1987 ; Morris and Seeherman 1990 ) up to 38% in draught breeds ( Brakenhoff et al. 2006 ; Perkins et al. 2009 ). There are a number of different surgical treatments currently available and more being developed. This article aims to discuss factors affecting choice of treatment and then provide an evidence‐based approach to describe surgical approaches, success rates and morbidity. Specific details of surgical methods are not given as they are readily available in surgical textbooks ( Stick 2006 ; McGorum et al. 2007 ). 相似文献
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Tamara Martin‐Gimnez Antonio M. Cruz Agustín Barragn Estefanía Montero Pedro G. Sanchez Guillermo Caballero Ignacio Corradini 《Journal of veterinary internal medicine / American College of Veterinary Internal Medicine》2019,33(6):2780-2785
Occipital condylar fractures (OCFs) causing delayed onset lower cranial nerve paralysis (LCNPs) are rare. We present a 7‐year‐old Friesian horse with delayed onset dysphagia caused by vagus nerve (CNX) paralysis and suspicion of glossopharyngeal nerve (CNIX) paralysis developed several days after a minor head injury. Endoscopic examination revealed right laryngeal hemiplegia and intermittent dorsal displacement of the soft palate. An area of submucosal hemorrhage and bulging was appreciated over the dorsal aspect of the medial compartment of the right guttural pouch. Radiological examination of the proximal cervical region showed rotation of the atlas and the presence of a large bone fragment dorsal to the guttural pouches. Occipital condyle fracture with delayed onset cranial nerve paralysis was diagnosed. Delayed onset cranial nerve paralysis causing dysphagia might be a distinguishable sign of OCF in horses. Delayed onset dysphagia after head injury should prompt equine clinicians to evaluate the condition of the atlanto‐occipital articulation and skull base. 相似文献
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Barazzoni AM Clavenzani P Chiocchetti R Bompadre GA Grandis A Petrosino G Costerbosa GL Bortolami R 《Research in veterinary science》2005,78(3):1654-253
The purpose of this investigation was to determine the central distribution of the efferent neurons of the recurrent laryngeal nerve (RLN) in the sheep by the use of the retrograde transport of the fluorescent tracer Fast Blue. The distribution of the RLN neurons was also compared with that of the neurons simultaneously labelled by injection of another tracer, Diamidino Yellow dihydrochloride, into the cervical trunk of the vagus nerve (CTV). Injections of the tracer into the CTV resulted in heavy retrograde labelling of neurons in the ipsilateral dorsal motor nucleus of the vagus nerve, in the nucleus ambiguus, in the nucleus retroambigualis and in the reticular formation surrounding the nucleus ambiguus. Following injections of the tracer into the RLN, labelling of neurons was seen over a wide area of the ipsilateral nucleus ambiguus and in the nucleus retroambigualis. Species differences in the distribution of the efferent component of the RLN are discussed, in particular ruminants compared to nonruminants. 相似文献
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Variability of resting endoscopic grading for assessment of recurrent laryngeal neuropathy in horses
J. D. PERKINS R. O. SALZ J. SCHUMACHER L. LIVESEY R. J. PIERCY S. Z. BARAKZAl 《Equine veterinary journal》2009,41(4):342-346
Reasons for performing study: The extent to which variability affects endoscopic grading of arytenoid cartilage movement is uncertain. Objective: To determine the observer and within horse variability of grading arytenoid cartilage movement in horses during resting endoscopic examination, using a 7‐grade system. Methods: Endoscopic recordings of the upper respiratory tract made at rest in 270 draught horses were reviewed independently by 2 veterinarians to assess interobserver variability when scoring horses' laryngeal function with a 7‐grade system. Grading was repeated by both examiners in 80 randomly selected recordings in order to assess intraobserver variability. In 120 horses, endoscopy was repeated after 24–48 h, with videos graded by both veterinarians to assess intrahorse variability. Results: The mean weighted κ statistic for concordance within examiners was 0.867, with a mean intraobserver agreement of 76.3%. The weighted κ statistic for concordance between the 2 examiners was 0.765, with an interobserver agreement of 63.1%. Of the horses receiving 2 endoscopic examinations, the same grade was assigned to 57.1% of horses at the second examination, when effects resulting from interobserver variability were removed. The mean weighted κ statistic for concordance between the grade assigned at first vs. second examinations was 0.588, indicating only moderate agreement. Conclusions and potential relevance: Intra‐ and interobserver reliability of resting endoscopic grading of arytenoid cartilage movement using a 7‐grade system was high when examinations were conducted by experienced veterinarians. However, there was moderate daily intrahorse variability, suggesting that results of resting endoscopic examinations performed on a single day should be interpreted with caution. 相似文献
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P. Cramp F. J. Derksen J. A. Stick F. A. Nickels K. E. Brown P. Robinson N. E. Robinson 《Equine veterinary journal》2009,41(8):729-734
Reasons for performing study: Little is known about the efficacy of bilateral ventriculectomy (VE) or bilateral ventriculocordectomy (VCE) in draught horses. Objectives: To compare the effect of VE and VCE on upper airway noise in draught horses with recurrent laryngeal neuropathy (RLN) by use of quantitative sound analysis techniques. Hypothesis: In competitive draught horses with grade 4 RLN, VE and VCE reduce upper airway noise during exercise, but VCE is more effective. Methods: Thirty competitive hitch or pulling draught horses with grade 4 RLN were evaluated for upper airway sound during exercise. Respiratory rate (RR), inspiratory (Ti) and expiratory time (Te), the ratio between Ti and Te (Ti/Te), inspiratory (Sli) and expiratory sound levels (Sle), the ratio between Sli and Sle (Sli/Sle), and peak sound intensity of the second formant (F2) were calculated. Eleven horses were treated with VE and 19 with VCE. After 90 days of voice and physical rest and 30 days of work, the horses returned for post operative upper airway sound evaluation and resting videoendoscopy. Results: VE significantly reduced Ti/Te, Sli, Sli/Sle and the sound intensity of F2. Respiratory rate, Ti, Te and Sle were unaffected by VE. VCE significantly reduced Ti/Te, Ti, Te, Sli, Sli/Sle and the sound intensity of F2, while RR and Sle were unaffected. The reduction in sound intensity of F2 following VCE was significantly greater than following VE. After VE and VCE, 7/11 (64%) and 15/18 (83%) owners, respectively, concluded that the surgery improved upper airway sound in their horses sufficiently for successful competition. Conclusions: VE and VCE significantly reduce upper airway noise and indices of airway obstruction in draught horses with RLN, but VCE is more effective than VE. The procedures have few post operative complications. Potential relevance: VCE is recommended as the preferred treatment for RLN in draught horses. Further studies are required to evaluate the longevity of the procedure's results. 相似文献
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Cross-sectional area of the aditus laryngis and rima glottidis before and after transection of the left recurrent laryngeal nerve in the horse 总被引:1,自引:0,他引:1
G S Martin R E Beadle P F Haynes J W Watters 《American journal of veterinary research》1986,47(2):422-425
The ventral-to-dorsal height of the rima glottidis was measured from lateral pharyngeal radiographs after correction for magnification. The rima glottidis height was used to enlarge accurately endoscopic photographs of 5 horses taken before and after transection of the left recurrent laryngeal nerve. Areas of the rima glottidis and aditus laryngis were measured, using a computerized digitizer. Mean area of the aditus laryngis was 1,908 mm2 before neurectomy and 1,346 mm2 after neurectomy (P = 0.025). Mean area of the rima glottidis was 1,198 mm2 before neurectomy and 805 mm2 after neurectomy (P = 0.025). Mean width of the rima glottidis was 31 mm before neurectomy and 20 mm after neurectomy (P = 0.001). Significant differences were not found between the pre- and postneurectomy heights of the rima glottidis. 相似文献
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K G Braund J E Steiss A E Marshall J R Mehta M Toivio-Kinnucan K A Amling 《American journal of veterinary research》1988,49(12):2111-2116
Morphologic and morphometric studies were performed on the vagus nerve and its major branch, the recurrent laryngeal nerve (RLN): (1) to determine normal histologic data in myelinated fibers of clinically normal young adult dogs, (2) to establish reference values for mean fiber diameter in the vagus nerve and in the proximal and distal portions of the RLN, and (3) to delineate relative frequency distribution curves for each nerve. Few degenerative changes were observed in single teased-nerve fiber preparations. There was no statistical difference between left and right sides of the vagus nerve or between the proximal and distal portions of the RLN (right and left sides). In contrast to the unimodal distribution of fibers in the vagus nerve and the proximal portion of the RLN, the distribution of fibers in the distal portion of the RLN was bimodal. Mean (+/- SD) fiber diameters of the vagus nerve and in the proximal portion of the RLN (3.02 +/- 1.44 microns and 3.63 +/- 1.49 microns, respectively) were not significantly different, despite a shift to large-diameter fibers in the latter. However, mean fiber diameters of distal and proximal portions of the RLN (5.56 +/- 1.88 microns and 3.63 +/- 1.49 microns, respectively) were significantly (P less than 0.001) different. Approximately 86% of fibers in the vagus nerve and 76% of fibers in the proximal portion of the RLN, had a diameter less than 5 microns, and about 70% of fibers in the distal portion of the RLN had a diameter greater than 5 microns.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
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A review of recent developments in the clinical application of prosthetic laryngoplasty for recurrent laryngeal neuropathy: Indications,complications and outcome 下载免费PDF全文
Recurrent laryngeal neuropathy (RLN) has been recognised for two centuries in horses. Surveys undertaken in Europe and the United States have reported that prosthetic laryngoplasty is the most common treatment for RLN, particularly for advanced cases. Despite widespread adoption of this surgical technique for treatment of RLN, reported success rates still vary widely, particularly in horses used for high intensity exercise where outcomes are often considered moderate, at best. Studies evaluating the outcome of the procedure are complicated by the use of variable criteria for measuring success, various modifications in the procedure, differing athletic demands in horses used in different equine disciplines and horses lost to follow‐up. Furthermore, post operative complications appear to be common, in particular, the effects of the surgery on airway dynamics which are not completely understood. Proposed modifications to the technique may provide a means of improving success rates; however, standardised objective measurements taken before and after surgery are required to effectively evaluate the potential benefits and outcomes of the procedure. 相似文献
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The establishment of a single validated endoscopic laryngeal grading system for assessing recurrent laryngeal neuropathy (RLN) is desirable to facilitate direct comparisons between the findings of different clinical and research groups worldwide. The objective of this study was to assess the relationship between the Havemeyer endoscopic laryngeal grading system and histopathological changes consistent with RLN in the left cricoarytenoideus dorsalis (CAD) muscle of horses of different breeds with a full range of clinical severities of RLN, i.e., from normal endoscopic laryngeal function to complete laryngeal hemiplegia. Endoscopic grading of laryngeal function of 22 horses was performed using the Havemeyer endoscopic laryngeal grading system. A biopsy sample of the left CAD muscle was obtained from each horse, either at post mortem examination (n = 16), or during routine laryngoplasty surgery (n = 6). A semi-quantitative histopathological scoring system was used to grade the severity of histopathological lesions consistent with RLN in the left CAD muscle of each horse. A significant positive correlation (rs = 0.705, p < 0.001) was found between the Havemeyer grades and sub-grades of laryngeal function and the semi-quantitative assessment of histopathological lesions consistent with RLN in the left CAD muscle. However, a wide spread of muscle histopathological scores was obtained, particularly from horses with Havemeyer sub-grades II.1, III.1 and III.2. In conclusion, the Havemeyer endoscopic laryngeal grading system was found to broadly correlate with histopathological changes consistent with RLN in equine cricoarytenoideus dorsalis muscle. 相似文献
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Experimental crush of the equine recurrent laryngeal nerve: a study of normal and aberrant reinnervation 总被引:2,自引:0,他引:2
Experimental reinnervation of the equine larynx in healthy ponies was studied after the recurrent laryngeal nerve was crushed, using endoscopic, electromyographic, and microscopic techniques. In 12 ponies, the recurrent laryngeal nerve was crushed unilaterally in the midcervical area. All showed postoperative paralysis of the larynx on the operated side. In 8 ponies, recovery of movement of the vocal folds occurred at different times (2.5 to 8 months) after surgical operation was done. These movements, which were often abnormal, included trembling and asynchronism. In 2 of these ponies, complete return of normal vocal fold function occurred. Return of function was due to reinnervation, as determined by electromyographic examination of the laryngeal muscles and microscopic evaluation of these muscles and the recurrent laryngeal nerves. In the muscles, there was evidence of fiber-type grouping, and the nerves showed regenerative activity. In 3 ponies, there was evidence of aberrant reinnervation, with adductor or abductor muscles discharging during an inappropriate phase of the respiratory cycle. Further evidence that reinnervation occurred in the larynges of these ponies was determined in microscopic sections of the recurrent laryngeal nerves and muscles, which showed regenerative activity and muscle fiber-type grouping, respectively. The endoscopic abnormalities in these ponies were compared with those seen in horses with spontaneous subclinical laryngeal paralysis. However, the possibility that the abnormal endoscopic findings in this latter group of horses are due to aberrant reinnervation is thought to be unlikely. 相似文献
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Genetic predispositions for guttural pouch tympany, recurrent laryngeal neuropathy and recurrent airway obstruction (RAO) are well documented. There is also evidence that exercise‐induced pulmonary haemorrhage and infectious diseases of the respiratory tract in horses have a genetic component. The clinical expression of equine respiratory diseases with a genetic basis results from complex interactions between the environment and the genetic make‐up of each individual horse. The genetic effects are likely to be due to variations in several genes, i.e. they are polygenic. It is therefore unlikely that single gene tests will be diagnostically useful in these disorders. Genetic profiling panels, combining several genetic factors with an assessment of environmental risk factors, may have greater value, but much work is still needed to uncover diagnostically useful genetic markers or even causative variants for equine respiratory diseases. Nonetheless, chromosomal regions associated with guttural pouch tympany, recurrent laryngeal neuropathy and RAO have been identified. The association of RAO with other hypersensitivities and with resistance to intestinal parasites requires further study. This review aims to provide an overview of the available data and current thoughts on the genetics of equine airway diseases. 相似文献
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I C Fulton F J Derksen J A Stick N E Robinson R Walshaw 《American journal of veterinary research》1991,52(9):1461-1467
The efficacy of a nerve muscle pedicle (NMP) graft in restoring upper airway function was evaluated in exercising horses with induced left laryngeal hemiplegia. The NMP graft was created from the first cervical nerve and the omohyoideus muscle and transplanted into the left cricoarytenoideus dorsalis muscle. Seven adult Standardbreds were trained to exercise on a treadmill inclined at 6.38 degrees. With the horses at rest and exercising at 4.2 and 7.0 m/s, the following variables were recorded: peak inspiratory and expiratory transupper airway pressures (defined as the pressure difference between a lateral tracheal catheter and a mask catheter), peak inspiratory and expiratory air flow, inspiratory and expiratory impedance, tidal volume, minute ventilation, heart rate, and respiratory frequency. Measurements were made before left recurrent laryngeal neurectomy (LRLN), 28 days after LRLN, and 12, 24, and 52 weeks after the NMP graft (n = 5) or sham operation (n = 2). Before LRLN, exercise increased inspiratory and expiratory air flow and transupper airway pressure, whereas the impedance was unchanged. After LRLN, transupper airway inspiratory pressure and impedance were significantly greater and inspiratory air flow was significantly less than baseline values at 7.0 m/s. The sham operation did not improve airway function. Twelve weeks after insertion of the NMP graft, inspiratory impedance and inspiratory air flow were significantly different (improved) from LRLN values. Twenty-four weeks after insertion of the NMP graft, inspiratory impedance was not significantly different from LRLN values.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献