Discussion

Pearson, A., O'Meara, B., Bladon, B.
Aim: To minimise the size of the skin incision when carrying out the laryngeal tie-forward procedure. Methods: In dorsal recumbency, a 3 cm incision was made over the cricoid cartilage on the ventral midline. Fibre Wire (5 metric) was secured around the right and left thyroid cartilage. A second 5 cm incision was made over the basihyoid bone extending caudally from the lingual process. The sutures were drawn from the caudal incision under the sternohyoideus muscle using Rochester Pean forceps. The sutures were drawn under the basihyoid bone from retrograde using a graft passer and the larynx tied forward as previously described by Woodie et al. (2005). Results: The procedure was carried out on 26 horses between April and October 2011. All horses recovered uneventfully from surgery and were discharged from the hospital. In all horses rostral and dorsal displacement of the larynx was confirmed by lateral radiographs, using the technique described by McCluskie et al. (2008). Intraoperative complications included haemorrhage at the site of suture placement both rostrally and caudally. One horse raced 3 times before an examination revealed a fracture of the stylohyoid bone. Conclusions: The minimally invasive tie- forward technique successfully advanced the larynx in all horses. The procedure was carried out using 2 small incisions, 3 cm and 5 cm in length rather than a 15 cm incision as previously described by Woodie et al. (2005). Practical significance: A smaller incision results in a more rapid healing time from surgery, enabling horses to return to training only 10 days after the laryngeal tie-forward procedure. The report also describes the use of a graft passer to secure the prosthesis around the basihyoid bone from retrograde. Fracture of the stylohyoid bone is a potential complication of a laryngeal tie-forward procedure in horses once returned to training.