title: Implications of different degrees of arytenoid cartilage abduction on equine upper airway characteristics.
abstract: BACKGROUND
  The necessary degree of arytenoid cartilage abduction (ACA) to restore airway patency at maximal exercise has not been determined.
  
  
  OBJECTIVE
  Use computational fluid dynamics modelling to measure the effects of different degrees of ACA on upper airway characteristics of horses during exercise.
  
  
  OBJECTIVE
  Maximal ACA by laryngoplasty is necessary to restore normal peak airflow and pressure in Thoroughbred racehorses with laryngeal hemiplegia.
  
  
  METHODS
  The upper airway was modeled with the left arytenoid in 3 different positions: maximal abduction; 88% cross-sectional area of the rima glottis; and 75% cross-sectional area of the rima glottis. The right arytenoid cartilage was maximally abducted. Two models were assumed: Model 1: no compensation of airway pressures; and Model 2: airway pressure compensation occurs to maintain peak airflow. The cross-sectional pressure and velocity distributions for turbulent flow were studied at peak flow and at different positions along the airway.
  
  
  RESULTS
  Model 1: In the absence of a change in driving pressure, 12 and 25% reductions in cross-sectional area of the larynx resulted in 4.11 and 5.65% reductions in peak airflow and 3.68 and 5.64% in tidal volume, respectively, with mild changes in wall pressure. Model 2: To maintain peak flow, a 6.27% increase in driving tracheal pressure was required to compensate for a cross-sectional reduction of 12% and a 13.63% increase in driving tracheal pressure was needed for a cross-sectional area reduction of 25%. This increase in negative driving pressure resulted in regions with low intraluminal and wall pressures, depending on the degree of airway diameter reduction.
  
  
  CONCLUSIONS
  Assuming no increase in driving pressure, the decrease in left ACA reduced airflow and tidal volume. With increasing driving pressure, a decrease in left ACA changed the wall pressure profile, subjecting the submaximally abducted arytenoid cartilage and adjacent areas to airway collapse.
  
  
  CONCLUSIONS
  The surgical target of ACA resulting in 88 % of maximal cross-sectional area seems to be appropriate.
authors.affiliation: Department of Biological and Environmental Engineering, College of Agriculture and Life Sciences, North Carolina State University, Raleigh, North Carolina 27606, USA.
authors.forename: V
authors.initials: V
authors.lastname: Rakesh
authors.forename: N G
authors.initials: NG
authors.lastname: Ducharme
authors.forename: J
authors.initials: J
authors.lastname: Cheetham
authors.forename: A K
authors.initials: AK
authors.lastname: Datta
authors.forename: A P
authors.initials: AP
authors.lastname: Pease
mesh_terms: D000402:Airway Obstruction / Q000175:diagnosis / Q000503:physiopathology / Q000662:veterinary; D000403:Airway Resistance / Q000502:physiology*; D000818:Animals; D001193:Arytenoid Cartilage / Q000502:physiology*; D006429:Hemiplegia / Q000175:diagnosis / Q000503:physiopathology / Q000662:veterinary; D006734:Horse Diseases / Q000175:diagnosis / Q000503:physiopathology; D006736:Horses / Q000033:anatomy & histology* / Q000502:physiology*; D008954:Models, Biological; D010805:Physical Conditioning, Animal / Q000502:physiology*; D012119:Respiration; D015656:Respiratory Mechanics / Q000502:physiology