Presentation of a novel method for equine vocal cordectomy in a thoroughbred racehorse post laryngoplasty

Considerable variation exists in the literature relating to vocal cord and/or ventricle (VC/V) surgical procedures, as an adjunct to laryngoplasty or as a sole treatment for laryngeal hemiplegia. This includes whether the procedure is necessary, which side to operate on, unilateral or bilateral procedure, which exact structure to remove, the timing as related to the laryngoplasty if an adjacent, and the complications resulting from the procedure elected, such as contributing to aspiration and dysphagia. This paper describes a novel approach, which is waiting until the final abduction post laryngoplasty is ascertained and then electing to operate only when noise and athletic performance suggests that a VC/V procedure is indicated. The novel technique was to use a modified punch intranasally in the standing horse under endoscopic guidance, similarly to an epiglottic entrapment hook, to transect the left vocal cord only in a minimalistic approach. This was ultimately successful in minimising the respiratory noise and returning the horse to competitive form 2 ½ years after a laryngoplasty, that had gradually lost abduction and settled in a grade 4 (Dixon)/Grade B (Rakestraw) position. A first unsuccessful partial transection of the leading edge was followed by a second total transection which appeared as apparently successful. This is a low-cost technique, within the realms of many practitioners, that deserves more evaluation both post laryngoplasty and as a sole treatment for laryngeal hemiplegia .