Update on recurrent laryngeal neuropathy

Abstract

Recurrent laryngeal neuropathy has long been recognised in the horse. However, despite decades of research and treatment of the condition, our understanding of how to best treat affected horses remains incomplete. The advent of overground exercising endoscopy has helped confirm the diagnosis and shown the complex nature of many airway obstructions. A consensus laryngeal grading system allows diagnostic data and treatment results from different populations to be more subjectively analysed. Advances in treatment include modifications to the prosthetic laryngoplasty surgery and development of laryngeal pacing using the cervical nerves to stimulate intrinsic laryngeal muscles at exercise. There is currently no single treatment appropriate for every affected horse, therefore owners must be carefully counselled after an accurate diagnosis has been reached, prior to choosing a surgical option. As many horses will still have complex dynamic airway collapse post-laryngoplasty, informed consent may help avoid the disappointment associated with perceived poor outcomes.