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Larynx: ventriculocordectomy
Synonym(s): Hobday, ventriculectomy/sacculectomy, cordectomy
Introduction
- The technique consists of removal of the mucus membrane lining the laryngeal ventricle leading to adhesions between the arytenoid and thyroid cartilages and reduced filling of the ventricles.
- Many different surgical methods have been used to treat laryngeal hemiplegia Larynx: hemiplegia .The technique of ventriculectomy or sacculectomy has been used for most of this century but recent research, particularly using video-endoscopy on animals exercising on a treadmill, has cast doubt on the ability of this technique alone to abduct and stabilize the arytenoid and vocal cords during exercise.
- Removal of the vocal cords (bilateral cordectomy) decreases airway obstruction when carried out alongside other procedures.
Uses
- Treatment of laryngeal hemiplegia Larynx: hemiplegia particularly the idiopathic form, often performed in conjunction with laryngoplasty Larynx: laryngoplasty , or as a single procedure in horses exercising at slow paces.
Advantages
- Relatively simple procedure.
- Possible in standing animal.
- Minimal complication rate.
- May modify and/or reduce respiratory noise (stridor) associated with hemiplegia.
Disadvantages
- Probably does not prevent dynamic collapse of laryngeal structures during exercise.
Alternative techniques
- Same as idiopathic laryngeal hemiplegia Larynx: hemiplegia including:
- Ventriculectomy/cordectomy via endoscopic surgery.
- Laryngoplasty Larynx: laryngoplasty .
- Permanent tracheostomy Trachea: tracheostomy - permanent .
- Tracheotomy Trachea: tracheotomy .
- Re-innervation techniques.
- Arytenoidectomy Larynx: arytenoidectomy .
Time required
Preparation
- Aseptic skin preparation: 10 min.
- Infiltration and action of local anesthetic: 10 min.
- General anesthesia induction and maintenance: 20 min.
- Laryngotomy: 10-15 min.
Procedure
- 5-10 min depending upon technique used and whether cordectomy done as well.
Decision taking
Criteria for choosing test
- Same as idiopathic laryngeal hemiplegia Larynx: hemiplegia but usually reserved for horses not undertaking significant exercise; racing for short distances with minimal resting asymmetry; economic reasons; and draft horses.
- Many surgeons perform a ventriculectomy +/- cordectomy along with laryngoplasty Larynx: laryngoplasty .
Risk assessment
- Post-operative upper respiratory tract obstruction.
Requirements
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Preparation
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Technique
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Aftercare
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Mason B J, Riggs C M & Cogger N (2013) Cohort study examining long-term respiratory health, career duration and racing performance in racehorses that undergo left-sided prosthetic laryngoplasty and ventriculocordectomy surgery for treatment of left-sided laryngeal hemiplegia. Equine Vet J 45 (2), 229-234 PubMed.
- Cramp P et al (2009) Effect of ventriculectomy versus ventriculocordectomy on upper airway noise in draught horses with recurrent laryngeal neuropathy. Equine Vet J 41 (8), 729-734 PubMed.
- Witte T H, Mohammed H O, Radcliffe C H, Hackett R P & Ducharme N G (2009) Racing performance after combined prosthetic laryngoplasty and ipsilateral ventriculocordectomy or partial arytenoidectomy: 135 Thoroughbred racehorses competing at less than 2400m (1997-2007). Equine Vet J 41(1), 70-75 PubMed.
- Robinson P et al (2007) Histological evaluation of the equine larynx after unilateral laser-assisted ventriculocordectomy. Equine Vet J 39 (3), 222-225 PubMed.
- Robinson P et al (2006) Effects of unilateral laser-assisted ventriculocordectomy in horses with laryngeal hemiplegia. Equine Vet J 38 (6), 491-496 PubMed.
- Taylor S E, Barakzai S Z & Dixon P (2006) Ventriculocordectomy as the sole treatment for recurrent laryngeal neuropathy: long-term results from ninety-two horses. Vet Surg 35 (7), 653-657 PubMed.
- Brown J A, Derksen F J, Stick J A, Hartmann W M & Robinson N E (2003) Ventriculocordectomy reduces respiratory noise in horses with laryngeal hemiplegia. Equine Vet J 35 (6), 570-574 PubMed.
- Dixon P M, McGorum D I et al (2003) Long-term survey of laryngoplasty and ventriculocordectomy in an older, mixed-breed population of 200 horses. Part 1: Maintenance of surgical arytenoid abduction and complications of surgery. Equine Vet J 35 (4), 389-396 PubMed.
- Dixon P M, McGorum B C et al (2003) Long-term survey of laryngoplasty and ventriculocordectomy in an older, mixed-breed population of 200 horses. Part 2: Owners' assessment of the value of surgery. Equine Vet J 35 (4), 397-401 PubMed.
- Lumsden M et al (1994) Evaluation of partial arytenoidectomy as a treatment for equine laryngeal hemiplegia. Equine Vet J 26 (2), 125-129 PubMed.
- Shires G M et al (1990) Preliminary study of laryngeal sacculectomy in horses, using a neodymium-yttrium aluminium garnet laser technique. Am J Vet Res 51 (8), 1247-1249 PubMed.