Effect of head position on radiographic assessment of laryngeal tie-forward procedure in horses

Abstract

Objective— To assess the effect of head position on relative position of the larynx and hyoid apparatus in horses with palatal dysfunction, and to define a standard position for radiographic assessment of laryngeal tie-forward. Study Design— Prospective clinical study. Animals— Adult horses (n=9) with palatal dysfunction. Methods— Left lateral radiographs of the larynx were obtained pre and postoperatively for 3 different head positions (flexed=90°; neutral=100°; extended=115°). Distance between thyrohyoid bone and thyroid cartilage was measured. Data were analyzed to investigate differences between head positions, and to compare differences between pre- and postoperative measurements. Results— Head position had a significant effect on relative position of the larynx and hyoid apparatus preoperatively. There was no significant difference in postoperative measurements of the 3 head positions. A significant difference between pre- and postoperative measurements was found with the head in the neutral or extended position whereas there were no significant differences between pre- and postoperative measurements using the flexed position. Conclusions— Head position affects the relationship between the hyoid apparatus and larynx preoperatively, with greatest distance occurring when the head is extended. In a flexed position, it is not possible to ascertain whether laryngeal position has changed postoperatively. Clinical Relevance— A standardized head position is necessary when assessing the laryngeal tie-forward procedure radiographically. An extended head position is most useful for this assessment.