Equine Health Update EHU Vol 20 Issue 01 - Page 13

Recurrent Laryngeal Neuropathy Modified first or second cervical nerve transplantation technique for the treatment of recurrent laryngeal neuropathy (RLN) in horses F. Rossignol O. Brandenberger J. D. Perkins J.‐P. Marie C. Mespoulhès‐Rivière N. G. Ducharme Background In horses, the only established method for reinner- vation of the larynx is the nerve‐muscle pedicle im- plantation, whereas in human medicine, direct nerve implantation is a standard surgical technique for se- lective laryngeal reinnervation in human patients suf- fering from bilateral vocal fold paralysis. Objectives 1. To describe a modified first or second cervical nerve transplantation technique for the treatment of recurrent laryngeal neuropathy (RLN) in horses and 2. evaluate the outcomes of reinnervation using direct nerve needle‐stimulation of the first cervical nerve and exercising endoscopy before and after surgery. Study design Case series Methods Nerve transplantation surgery, in which the first or sec- ond cervical nerve is tunnelled through the atrophied left cricoarytenoideus dorsalis muscle, was performed in combination with ipsilateral laser ventriculocordec- tomy. Ultrasound‐guided stimulation of the first cer- vical nerve at the level of the alar foramen was used to confirm successful reinnervation post‐operatively. Exercising endoscopy was performed before and after surgery. The exercising RLN grade of the left arytenoid was blindly determined at the highest stride frequency for each examination. • Volume 20 Issue 1 | April 2018 • 13