Trattamento chirurgico della neuropatia ricorrente nel cavallo

Abstract

Equine recurrent laryngeal neuropathy (RLN) has long been recognized in larger breeds of horses as a cause of laryngeal airway obstruction. It causes a decrease in airflow to the lungs that may lead to exercise intolerance and production of abnormal respiratory noise during work (“roaring”). It is caused by paralysis of one or both the arytenoid cartilages, due to the lack of innervation that determines atrophy of the muscles that move these cartilages. The left side of the larynx is most commonly affected. Although several hypotheses tried to explain the etiology and pathogenesis of this disease, the exact cause of RLN remains uncertain. Over the last 150 years, the treatment of this disorder has received much attention in the literature. Nowadays, surgical treatments available for RLN include prosthetic laryngoplasty, ventriculectomy, ventriculocordectomy, laryngeal reinnervation and, occasionally, partial arytenoidectomy and tracheostomy. Presently, prosthetic laryngoplasty (also known as “tie-back”) is the technique of choice for the treatment of RLN in horses in which airway obstruction is the main concern. If noise reduction is required, surgeons often use vocal cordectomy, ventriculectomy or ventriculocordectomy alone or to supplement prosthetic laryngoplasty. All these techniques have several post-operative complications, such as coughing, airway contamination and failure. For these reasons, researchers are now exploring new paths of investigation: injection of autologous stem cells near the left recurrent laryngeal nerve and nerve or muscle electrical stimulation (functional electrical stimulation, FES).