Reasons for performing study: The success of combined prosthetic laryngoplasty with ipsilateral ventriculocordectomy (LPVC) has not been compared to that of partial arytenoidectomy (PA) in a clinical population.
Hypotheses: In Thoroughbred (TB) racehorses: 1) earnings after LPVC are unaffected by the severity of recurrent laryngeal neuropathy (RLN) (laryngeal
grade III vs.
grade IV); 2) LPVC and PA yield similar results in the treatment of
grade III RLN; 3) performance outcome following PA is independent of diagnosis (RLN vs. unilateral arytenoid chondritis [UAC]); and 4) neither LPVC nor PA returns horses to the level of performance of controls.
Methods: Medical and racing records of 135 TB racehorses undergoing LPVC or PA for the treatment of
grade III or
IV RLN or UAC were reviewed. Racing records of age and sex matched controls were also reviewed.
Results: After LPVC, horses with
grade III RLN performed better compared to those with
grade IV RLN. Furthermore, horses treated for
grade III RLN by LPVC showed post operative earnings comparable to controls. Rate of return to racing were similar for PA and LPVC, although LPVC resulted in higher post operative earnings. Performance after PA was similar regardless of diagnosis (UAC or RLN). Finally, neither LPVC when performed for
grade IV RLN, nor PA performed for either diagnosis restored post operative earnings to control levels.
Conclusions: Thoroughbred racehorses treated by LPVC for
grade III RLN show significantly better post operative earnings compared to horses treated for
grade IV disease. In
grade III RLN, LPVC returns earning potential to control levels. PA and LPVC lead to similar success in terms of rate of return to racing, but PA leads to inferior earnings after surgery.
Potential relevance: Laryngoplasty should be recommended for all TB racehorses with
grade III RLN to maximise return to racing at a high level. This contradicts the common approach of waiting for complete paralysis.
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