To compare laryngeal impedance, in terms of air flow and pressure, following arytenoid corniculectomy (COR) versus 3 other airway interventions (left-sided laryngoplasty with ipsilateral ventriculocordectomy [LLP], LLP combined with COR [LLPCOR], and partial arytenoidectomy [PA]) performed on cadaveric equine larynges with simulated left recurrent laryngeal neuropathy (RLN) and to determine whether relative laryngeal collapse correlated with the interventions performed.
28 cadaveric equine larynges.
Each larynx in states of simulated left RLN alone and with airway interventions in the order LLP, LLPCOR, COR, and PA was evaluated in a box model construct that replicated upper airway flow mechanics consistent with peak exercise in horses. Results for impedance, calculated from airflow and pressure changes, were compared between states for each larynx. Multivariable mixed-effects analysis controlling for repeated measures within larynx was performed to calculate the predicted mean impedance for each state.
Results indicated that tracheal adapter diameter, individual larynx properties, airway intervention, and relative laryngeal collapse affected laryngeal impedance. The LLP and LLPCOR interventions had the lowest impedance, whereas the COR and PA interventions did not differ substantially from the simulated left RLN state. Residual intraclass correlation of the model was 27.6 %.
CONCLUSIONS AND CLINICAL RELEVANCE
Although impedance was higher for the simulated left RLN with the COR intervention state than with the LLP intervention state, given the clinical success of PA for treating RLN in horses and the similar results for the COR and PA intervention states in the present study, the use of COR warrants further investigation. The residual interclass correlation suggested that individual laryngeal variation affected impedance and may have a clinical effect.
To evaluate the bactericidal properties of chlorhexidine diacetate (CHD) after potentiation with EDTA and Tris buffer (EDTA-Tris), and to find a potentiated CHD concentration that would achieve 90 to 100% killing for all bacteria tested.
6 adult ponies.
Serial dilutions of CHD, CHD in EDTA-Tris, and EDTA-Tris alone were evaluated for bactericidal activity against Staphylococcus aureus, Escherichia coli, and Streptococcus zooepidemicus. The tarsocrural joints of 6 ponies were lavaged with either 1 L of phosphate buffered saline solution (control) or 1 L of 0.0005% CHD in EDTA-Tris. Synovial fluid was collected before lavage and on days 1,4, and 8. Synovia, cartilage, and bone with cartilage were collected on day 8 when the ponies were euthanatized.
In vitro results indicated that 0.0005% CHD in EDTA-Tris was 90% lethal to all bacteria tested. Results of synovial fluid analysis, glycosaminoglycan analysis, and histologic examination of the synovial membrane and articular cartilage indicated that joint lavage with 0.0005% CHD in EDTA-Tris was not detrimental to the synovium or the articular cartilage of pony tarsocrural joints. Changes observed were a result of the actual lavage process, the phosphate-buffered saline solution, and hemarthrosis.
A concentration of 0.0005% CHD in EDTA-Tris was 90% lethal to all bacteria tested. Pony tarsocrural joint lavage with 0.0005% CHD in EDTA-Tris was not detrimental to the synovium or the articular cartilage. The efficacy of 0.0005% CHD potentiated with EDTA-Tris as a potential joint lavage fluid for treatment of infectious arthritis needs to be evaluated in clinical patients. (Am J Vet Res 1996; 57:756–761)