A Modified Laryngeal Tie-Forward Procedure Using Metallic Implants for Treatment of Dorsal Displacement of the Soft Palate in Horses

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Objective:To describe a modified laryngeal tie-forward procedure (LTFP) using metallic implants.Study Design:Retrospective case series.Population:Twenty-seven horses (including 24 race horses) with dorsal displacement of the soft palate (DDSP) or palatal instability (PI) diagnosed using high-speed treadmill endoscopy (n = 15), history and resting examination (n = 8), or dynamic endoscopy over ground (n = 4).Methods:All horses underwent the modified LTFP. Modifications of the surgical procedure consisted in the use of 3 metallic stents called Suture ButtonTM through which the sutures are threaded and in a tying technique that involved a single knot connecting left and right suture loops (versus tying each separately). Lateral radiographs were taken 24 hours after surgery. Follow-up was obtained by telephone communication with trainers or owners.Results:Surgery was performed without complications on all horses. The 3 metallic buttons were clearly visible on the postoperative radiographic examination. No evidence of suture breakage was observed 24 hours postoperatively based on radiographs.Conclusion:In other aspects, this technique is not very different from that originally described by Ducharme et al; it is an innovation that could offer some advantages to the surgeons and increase suture resistance to pullout from the thyroid cartilage. Our technique was used without complication in a small group of horses and return to performance may be similar to the original technique.

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