title: Effect of prosthesis number and position on rima glottidis area in equine laryngeal specimens.
abstract: OBJECTIVE
  To assess the effect of 1 or 2 laryngeal prosthetic sutures on rima glottidis areas in equine laryngeal specimens.
  
  
  METHODS
  Experimental, randomized design.
  
  
  METHODS
  Cadaveric equine larynges (n=16).
  
  
  METHODS
  Larynges were collected from 10 horses; 2 sutures each were preplaced in the right and left sides of each larynx. A dorsal suture (DS) was placed through the caudal rim of the dorsal midline of the cricoid cartilage, under the cricopharyngeus muscle and through the proximal and rostral aspect of the muscular process. A lateral suture (LS) was placed 1.5 cm lateral to the DS and through the muscular process more distal and caudal to the 1st suture. Larynges were positioned in a customized stand and the rima glottidis photographed after each suture (LS or DS) or suture combination (CS) was tied in random sequence. An additional 6 larynxes were used to determine whether the tension applied to the sutures was repeatable. Sutures were preplaced in both the right and left side of each larynx as described above and each suture and CS was tied and released 3 times in each larynx. Photographs were taken of the rima glottidis after each suture or CS was tied generating 3 replicates for each suture configuration on each side of the 6 larynges.
  
  
  RESULTS
  Mean rima glottidis area was not different between DS and LS when tied alone (P=.85); however, mean area after CS (DS+LS) was greater than DS (P<.001) and LS (P<.001) alone. The coefficient of variation for the 6 suture patterns were low (1-7%) and the intraclass correlation coefficient estimates were very high (0.997-0.998) demonstrating excellent repeatability between replicates for each of the 3 suture configurations.
  
  
  CONCLUSIONS
  Our results suggest that laryngoplasty using 2 prostheses; 1 placed dorsally in the cricoid and through the rostral and proximal muscular process and 1 placed 1.5 cm lateral to the 1st and more caudal and distal in the muscular process results in a greater cross sectional area of the rima glottidis than either suture used alone.
  
  
  CONCLUSIONS
  Seemingly prosthetic sutures contribute independently to each other in determining the contour of the rima glottidis. Use of 2 prosthetic sutures improves crosssectional area of the rima glottidis compared with each suture alone and may improve surgical outcome in laryngoplasty.
authors.affiliation: Faculty of Veterinary Science, The University of Sydney, Camden and Austvet Animal Health Services, Toowoomba, Australia. andrewd@camden.usyd.edu.au
authors.forename: Andrew
authors.initials: A
authors.lastname: Dart
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Tee
authors.forename: Moses
authors.initials: M
authors.lastname: Brennan
authors.forename: Christina
authors.initials: C
authors.lastname: Dart
authors.forename: Nigel
authors.initials: N
authors.lastname: Perkins
authors.forename: Stella
authors.initials: S
authors.lastname: Chapman
authors.forename: Sally
authors.initials: S
authors.lastname: Debney
mesh_terms: D000818:Animals; D005931:Glottis / Q000601:surgery*; D006734:Horse Diseases / Q000601:surgery*; D006736:Horses; D013537:Sutures / Q000662:veterinary*; D014826:Vocal Cord Paralysis / Q000601:surgery / Q000662:veterinary*