title: Surgical Treatment of Iatrogenic Ventral Glottic Stenosis Using a Mucosal Flap Technique.
abstract: OBJECTIVE
  To describe a novel surgical technique for correcting postoperative ventral glottic stenosis (cicatrix or web formation) and the outcome in 2 Thoroughbred racehorses.
  
  
  METHODS
  Retrospective case report.
  
  
  METHODS
  Thoroughbreds diagnosed with ventral glottic stenosis (n=2).
  
  
  METHODS
  Horses presenting with iatrogenic ventral glottic stenosis and resultant exercise intolerance and abnormal exercise-related noise were anesthetized and a midline sagittal skin incision was made over the ventral larynx and between the sternohyoideus muscles overlying the cricothyroid notch. The cricothyroid ligament, attached laryngeal cicatrix, and overlying mucosa were sagittally sectioned at the dorsal aspect of the cicatrix on the left side. The laryngeal mucosa, cicatrix, and underlying cricothyroid ligament immediately rostral and caudal to the cicatrix were sectioned in a medial (axial) direction as far as the right side of the cricothyroid notch. After resection of the majority of the attached cicatrix tissue, the residual mucosal flap (attached to the right side of the larynx) was reflected ventrally and sutured to the attachment of the cricothyroid ligament on the right side of the cricothyroid notch, creating an intact mucosal layer on the right side of the ventral larynx.
  
  
  RESULTS
  Both horses had good intralaryngeal wound healing with minimal redevelopment of ventral glottic stenosis at 5 and 9 months postoperatively and were successfully returned to racing with complete absence of abnormal respiratory noise.
  
  
  CONCLUSIONS
  The unique laryngeal anatomy of horses, with a cartilage-free ventral laryngeal area (cricothyroid notch), allowed the use of this novel surgical technique to successfully treat ventral glottic stenosis.
authors.affiliation: The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Justine
authors.initials: J
authors.lastname: Kane-Smyth
authors.affiliation: The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Barnett
authors.affiliation: The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Mark O'Leary
authors.affiliation: The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Padraic M
authors.initials: PM
authors.lastname: Dixon
mesh_terms: D000818:Animals; D003251:Constriction, Pathologic / Q000601:surgery / Q000662:veterinary; D005260:Female; D005931:Glottis / Q000601:surgery*; D006734:Horse Diseases / Q000601:surgery*; D006736:Horses; D007049:Iatrogenic Disease / Q000662:veterinary; D007818:Laryngeal Diseases / Q000601:surgery / Q000662:veterinary*; D007820:Laryngeal Mucosa / Q000601:surgery; D008297:Male; D010805:Physical Conditioning, Animal; D011183:Postoperative Complications / Q000601:surgery / Q000662:veterinary; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000662:veterinary*