Peer-reviewed veterinary case report
Induration of the cricoid cartilage complicates prosthetic laryngoplasty in a horse.
- Journal:
- Veterinary surgery : VS
- Year:
- 2010
- Authors:
- Tatarniuk, Dane M et al.
- Affiliation:
- Department of Large Animal Clinical Sciences · Canada
- Species:
- horse
Plain-English summary
In this case, an 11-year-old American Paint gelding with severe left laryngeal paralysis underwent a surgical procedure called prosthetic laryngoplasty, which is done to help with breathing. During the surgery, the veterinarians had trouble passing a needle through a part of the horse's throat called the cricoid cartilage, and the needle even broke before they could successfully complete the task with a new needle. After the horse passed away, further examination showed that the cricoid cartilage had hardened, which was confirmed by X-rays and tissue analysis. This hardening is thought to happen as horses age and may have contributed to the difficulties faced during the surgery. Overall, the complications during the procedure highlight the importance of checking the larynx before surgery to identify any potential issues.
Abstract
OBJECTIVE: To report intraoperative complications during needle penetration and suture placement through the cricoid cartilage during a prosthetic laryngoplasty procedure. STUDY DESIGN: Case report. METHODS: An 11-year-old American Paint gelding with grade IV left laryngeal hemiplegia underwent a terminal prosthetic laryngoplasty for teaching purposes. Passage of the needle through the cricoid cartilage was difficult and resulted in needle breakage before eventual success using a new needle. The larynx was examined postmortem. RESULTS: Palpation of the larynx revealed hardening of the cricoid cartilage. Radiographic examination indicated the presence of diffuse radiopaque speckling. Histologic examination did not find accumulations of calcium salts, rather it revealed a loss of proteoglycans within the cricoid cartilage. CONCLUSIONS: Laryngeal mineralization occurs in the horse and human with advancing age. The loss of proteoglycan and subsequent stiffening of the cricoid cartilage likely resulted in the intraoperative complications noted in this report. CLINICAL RELEVANCE: Radiographic examination of the larynx before performing a prosthetic laryngoplasty may reveal the presence of areas of increased radiodensity. The interpretation of this is to be made with caution as it may represent mineralization, or hardening due to the changes in proteoglycan concentration, monomer size or charge.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/20210957/