Laryngeal Hemiplegia Research Articles

Explainable machine learning for assessing upper respiratory tract of racehorses from endoscopy videos

Laryngeal hemiplegia (LH) is a major upper respiratory tract (URT) complication in racehorses. Endoscopy imaging of horse throat is a gold standard for URT assessment. However, current manual assessment faces several challenges, stemming from the poor quality of endoscopy videos and subjectivity of manual grading. To overcome such limitations, we propose an explainable machine learning (ML)-based solution for efficient URT assessment. Specifically, a cascaded YOLOv8 architecture is utilized to segment the key semantic regions and landmarks per frame. Several spatiotemporal features are then extracted from key landmarks points and fed to a decision tree (DT) model to classify LH as Grade 1,2,3 or 4 denoting absence of LH, mild, moderate, and severe LH, respectively. The proposed method, validated through 5-fold cross-validation on 107 videos, showed promising performance in classifying different LH grades with 100%, 91.18%, 94.74% and 100% sensitivity values for Grade 1 to 4, respectively. Further validation on an external dataset of 72 cases confirmed its generalization capability with 90%, 80.95%, 100%, and 100% sensitivity values for Grade 1 to 4, respectively. We introduced several explainability related assessment functions, including: (i) visualization of YOLOv8 output to detect landmark estimation errors which can affect the final classification, (ii) time-series visualization to assess video quality, and (iii) backtracking of the DT output to identify borderline cases. We incorporated domain knowledge (e.g., veterinarian diagnostic procedures) into the proposed ML framework. This provides an assistive tool with clinical-relevance and explainability that can ease and speed up the URT assessment by veterinarians.

Implementation of a prototype dynamic laryngoplasty system in standing sedated horses provided arytenoid abduction control at seven days postoperatively.

Evaluate a prototype dynamic laryngoplasty system (DLPS) in horses; a feasibility study. 7 healthy Standardbred adult horses. This was an in vivo experimental study. Horses had a standing surgical procedure to induce complete laryngeal hemiplegia, which was subsequently treated using the dynamic laryngoplasty system (DLPS). Activation of the DLPS was achieved using an injection port exiting through the skin (n = 2) or a subcutaneous injection port (n = 5). For each horse, endoscopic examinations of the upper respiratory tract were performed preoperatively, intraoperatively, and 7 days postoperatively. Left-to-right quotient ratios calculated during inactivated and activated states were obtained from still images of the rima glottidis acquired during day 7. In 3 horses, the device was intentionally overinflated to evaluate for device failure, and postmortem examinations were performed on day 7. For the remaining 4 horses, upper respiratory tract endoscopy was repeated at 1 month postoperatively, with no subsequent postmortem exam. No perioperative complications occurred, and the DLPS was effectively delivered in all horses under standing sedation. The left-to-right quotient ratio at day 7 postoperatively could be altered from a resting position of 0.76 (± 0.06) to a maximum of 0.97 (± 0.06; P < .05). The degree of arytenoid abduction could not be significantly altered after 1 month of device implantation, suspected to be due to peri-implant fibrosis. No coughing nor tracheal contamination was observed at all time points or during inflation. The ability to alter the degree of abduction at 7 days postoperatively with the DLPS may be beneficial in selective cases.

Standing left recurrent laryngeal neurectomy for prospective evaluation of laryngeal hemiplegia evaluated by a high-speed treadmill test.

To describe left recurrent laryngeal neurectomy (LRLn) performed under standing sedation and evaluate the effect of LRLn on upper respiratory tract function using a high-speed treadmill test (HST). We hypothesized that (1) unilateral LRLn could be performed in standing horses, resulting in ipsilateral arytenoid cartilage collapse (ACC); and (2) HST after LRLn would be associated with alterations in upper respiratory function consistent with dynamic ACC. 6 Thoroughbred horses. The horses were trained and underwent a baseline HST up to 14 m/s at 5% incline until fatigue. Evaluation included; airflow, pharyngeal and tracheal pressures, and dynamic upper respiratory tract endoscopy. Trans-laryngeal impedance (TLI) and left-to-right quotient angle ratio (LRQ) were calculated after testing. The following day, standing LRLn was performed in the mid-cervical region. A HST was repeated within 4 days after surgery. Standing LRLn was performed without complication resulting in Havemayer grade 4 ACC at rest (complete paralysis) and Rakestraw grade C or D ACC (collapse up to or beyond rima glottis midline) during exercise. Increasing treadmill speed from 11 to 14 m/s increased TLI (P < .001) and reduced LRQ (P < .001). Neurectomy resulted in an increase in TLI (P = .021) and a reduction in LRQ (P < .001). Standing LRLn induces laryngeal hemiplegia that can be evaluated using a HST closely after neurectomy. Standing LRLn may be useful for future prospective evaluations of surgical interventions for laryngeal hemiplegia.

Hemiplegia laríngea traumática em bovinos - relato de caso

ABSTRACT Laryngeal hemiplegia is characterized by paralysis or paresis of one or both arytenoid cartilages, frequently reported in horses. In cattle no reports have been found yet. The diagnosis is based on clinical signs, endoscopy, and ultrasound findings. The aim of this study is to report a case of laryngeal hemiplegia in cattle, regarding the etiology and importance of imaging methods for the diagnosis of diseases in bovine medicine.

Prevalence of Exercise-Induced Pulmonary Hemorrhage, Tracheal Mucus and Recurrent Laryngeal Neuropathy in Competitive Draft Pulling Horses.

Respiratory disease is common in the horse population and is often be associated with poor performance in equine athletes. Despite their outstanding strength and aerobic capacity, little regard is given to draft horses and the respiratory disorders they may encounter when performing athletic activity. For this reason, the objectives of this study were: (1) to determine the prevalence of exercise-induced pulmonary hemorrhage (EIPH), tracheal mucus (TM) and recurrent laryngeal hemiplegia (RLH) in a population of competitive draft pulling horses, and (2) to determine if there was an association between horse weight, height, age, amount pulled, or competition placing with EIPH, TM or RLH in draft pullers. Results of this study identified EIPH in 26% of the study population, RLH in 32% and TM in 82% of participating horses; however, no risk factors were identified for the development of these problems in draft pulling horses.

A model of transient laryngeal hemiplegia in dogs through conduction blockade of the recurrent laryngeal nerve.

To create a model of transient unilateral laryngeal paralysis (LP) that will allow the study of cricoarytenoideus dorsalis dysfunction and a method for quantification of varying degrees of LP in dogs. 5 castrated male research Beagles. Between January and February 2018, dogs were anesthetized and instrumented with a laryngeal mask airway and a flexible endoscope to record the rima glottidis. The left or right recurrent laryngeal nerve (RLn) was localized using ultrasonography and electrical stimulation, then conduction blockade was induced with perineural lidocaine. The normalized glottal gap area (NGGA) was measured before and every 15 minutes after the block. Inspired 10% carbon dioxide (CO2) was administered for 1 minute at each sampling time. The inspiratory increase in NGGA (total and each side) was measured at peak inspiration. The change in hemi-NGGA for the control side versus the anesthetized side was evaluated with a mixed-effect model. During CO2 stimulation, the increase in inspiratory hemi-NGGA was consistently less (P < .001) for the treated side (-8% to 13%) versus the control side (49% to 82%). A compensatory increase (larger than at baseline) in the control hemi-NGGA was observed. The total NGGA remained unaffected. Unilateral local anesthesia of the RLn produced transient unilateral LP with a compensatory increase in the hemi-NGGA for the contralateral side. This model could facilitate the evaluation of respiratory dynamics, establishment of a grading system, and collection of other important information that is otherwise difficult to obtain in dogs with LP.

Computed tomographic geometrical analysis of surgical treatments for equine recurrent laryngeal neuropathy.

To characterize the 3-D geometry of the equine larynx replicating laryngeal hemiplegia and 4 surgical interventions by use of CT under steady-state airflow conditions. Secondly, to use fluid mechanic principles of flow through a constriction to establish the relationship between measured airflow geometries with impedance for each surgical procedure. 10 cadaveric horse larynges. While CT scans were performed, inhalation during exercise conditions was replicated for each of the following 5 conditions: laryngeal hemiplegia, left laryngoplasty with ventriculocordectomy, left laryngoplasty with ipsilateral ventriculocordectomy and arytenoid corniculectomy, corniculectomy, and partial arytenoidectomy for each larynx while CT scans were performed. Laryngeal impedance was calculated, and selected cross-sectional areas were measured along each larynx for each test. Measured areas and constriction characteristics were analyzed with respect to impedance using a multilevel, mixed-effects model. Incident angle, entrance coefficient, outlet coefficient, friction coefficient, orifice thickness, and surgical procedure were significantly associated with upper airway impedance in the bivariable model. The multivariate model showed a significant influence of incident angle, entrance coefficient, and surgical procedure on impedance; however, the orifice thickness became nonsignificant within the model. Laryngeal impedance was significantly associated with the entrance configuration for each procedure. This suggested that the equine upper airway, despite having a highly complex geometry, adheres to fluid dynamic principles applying to constrictions within pipe flow. These underlying flow characteristics may explain the clinical outcomes observed in some patients, and lead to areas of improvement in the treatment of obstructive upper airway disease in horses.

Traqueostomia permanente em equino: relato de caso

Problems related to the locomotor and gastrointestinal systems correspond to the highest percentage of clinical cases. However, diseases related to the respiratory system can result in low animal performance or even the animal’s removal from athletic life. This paper aims to report a case of permanent tracheotomy in a horse. The animal was treated at the Jerônimo Dix-Huit Rosado Maia Veterinary Hospital - HOVET, with respiratory noise and dyspnea claims. In the anamnesis, the owner reported that the animal had been presenting respiratory difficulty for 20 days. On physical examination, respiratory noise and dyspnea were noted. Endoscopy was performed, from which a marked decrease in the arytenoid cartilage movement on the right and left sides was noted. It was possible to diagnose a stage IV case of bilateral laryngeal hemiplegia, combining clinical signs with endoscopy findings. Thus, the surgical treatment of permanent tracheostomy was chosen. After surgery, drug therapy using antibiotics and anti-inflammatory drugs was performed. In addition, a nº 6 metal tracheostomy cannula was inserted. After 36 days of hospitalization, the animal was discharged with regression of clinical signs.

Validation of the Acoustic Voice Quality Index in the Russian language

Of this study was to validate the Acoustic Voice Quality Index (AVQI) in Russian language and determine threshold values to differentiate normal and dysphonic voices in russophone population. 41 recordings of patients with laryngeal hemiplegia and hemiparesis appeared after thyroid carcinomas' surgical treatment and laryngeal cancer from the Tomsk Cancer Research Institute were used, as well as 10 new recordings of normophonic people, composing a control group. Voice samples included the first quatrain of the poem «Sail» written by M.Yu. Lermontov, and sustained vowel «a». Four specialists who work with voice disorders (three speech-language pathologists and one phoniatrist) rated degree of dysphonia for all voice sample. Moreover, the AVQI was calculated for each sample. There was a statistically significant correlation between auditory-perceptual assessment and the AVQI (r=0.74), this confirms that AVQI is effective in evaluating voice disorders. The group of people with normal voice had relatively low values of AVQI, whereas the group of patients with laryngeal diseases had relatively high values. Analysis of ROC-curve showed that AVQI has excellent diagnostic accuracy to differentiate normal and dysphonic voices (AUC=0.966). The AVQI is the excellent tool for objective assessment of voice disorders in the Russian population/.

Quantitative assessment of progressive laryngeal hemiplegia in a 4-year-old beagle.

Progression of unilateral laryngeal paralysis (LP) was quantified in an asymptomatic 4-year-old beagle during spontaneous breathing stimulated with inhaled 10% CO2. Laryngeal evaluation was performed sequentially to track progression of LP over an 18-month period. Videos of the larynx during CO2-stimulated breathing were obtained under propofol anaesthesia. Maximal inspiratory normalised glottal gap area (NGGA) was determined on each occasion for left and right hemiglottis. Left NGGA was smaller than the right side throughout the period of follow-up. After 18 months, LP had progressed to such a degree that the left arytenoid was completely paralysed with no movement during inspiration. This case report demonstrates the possibility of early detection of LP, and quantification of progression. Early detection may allow regenerative surgical strategies for LP to maintain glottic area and reduce postoperative complication rates.

Impact of endotracheal tube size and cuff pressure on tracheal and laryngeal mucosa of adult horses

ObjectiveTo assess the effects of two sizes of silicone endotracheal tubes with internal diameter 26 mm (ETT26) and 30 mm (ETT30) inflated to minimum occlusive volume on tracheal and laryngeal mucosa of adult horses anesthetized for 2 hours with isoflurane. Study designProspective, randomized, blinded, crossover experimental study. AnimalsA total of eight healthy adult mares. MethodsUpper airway endoscopy and ultrasound measurements of internal tracheal diameter were performed the day before anesthesia. Horses were anesthetized and orotracheally intubated with ETT26 or ETT30. Ease of intubation was scored. The cuff was inflated in 10 mL increments to produce a seal. Final volume of air used and intracuff (IC) pressure (measured by pressure transducer) were recorded. At the end of anesthesia, a manometer was used to measure IC pressure and these measurements compared against measurements from the pressure transducer. Laryngeal and tracheal mucosa were assessed via endoscopy and assigned a score 0–3 before anesthesia, and at 2 and 24 hours following extubation. ResultsData are from seven horses because one horse with laryngeal hemiplegia was excluded. Mean tracheal ultrasound measurement was 3.5 ± 0.4 cm. No significant differences were noted between endotracheal tube sizes for intubation score, IC pressures, inflation volumes or tracheal or laryngeal injury scores at any time point. IC pressure measured by manometer was slightly higher than that by transducer (+1.0 ± 2.8 mmHg). Conclusions and clinical relevanceResults identified no clear advantage of one endotracheal tube size over the other in the population of horses studied, when endotracheal intubation is properly applied and IC pressure is carefully monitored. However, given that ETT26 was associated with the highest observed IC pressures and the only observed incidents of tracheal circumferential erythema, the larger ETT30 may be the better choice in most cases where tracheal size is sufficient.

Evidence-based Application of Acupuncture in Equine Practice

Traditional Chinese Veterinary Medicine (TCVM) including acupuncture has been used to treat disease and relieve pain in horses for more than 2,000 years. A review of the current knowledge of the mechanisms of acupuncture stimulation is presented. An emphasis is placed on electro-acupuncture, which can release neurotransmitters such as 5-hydroxytryptamine (serotonin) and endogenous opioids including β-endorphin, to relieve pain. Acupuncture has been shown to be a viable integrative treatment for equine back pain, foot pain, cervical stiffness, laryngeal hemiplegia and infertility. Acupoint sensitivity on palpation may be useful for the assessment of lameness along with conventional diagnostics in horses. Future well-designed studies are needed in order to strengthen the recommendation for acupuncture in the diagnosis and treatment of clinical conditions in horses.

Relation between exercise-induced pulmonary hemorrhage and findings in upper airway and trachea in Thoroughbred racehorses

This retrospective study aimed to investigate the relationship between exercise-induced pulmonary hemorrhage (EIPH) and upper airway disorders in Thoroughbred racehorses that competed at the Sao Paulo Jockey Club between 1999 and 2005. Data were collected from 4,036 endoscopic examinations performed 30 min after a race by the same examiner. The association between upper airway disorders and EIPH was assessed using the chi-square test. In total, 2299 and 1737 horses received and did not receive furosemide before a race, respectively. The incidence of EIPH in medicated and non-medicated horses was 52.4% and 60%, respectively. Among horses with left-sided laryngeal hemiplegia or dorsal displacement of the soft palate, 61.0% and 64.1% of them had EIPH, respectively. There was no relationship between EIPH and other upper airway disorders, such as pharyngeal lymphoid hyperplasia and mucopurulent discharge draining from guttural pouch openings. Left-sided laryngeal hemiplegia and dorsal displacement of the soft palate were positively associated with EIPH, but the association was statistically significant only for dorsal displacement of the soft palate (p < 0,05).

Transendoscopic Ventriculocordectomy Using Monopolar Electrosurgical Instrumentation for Conjunctive Treatment of Laryngeal Hemiplegia in Horses: 24 Cases (2017-2019).

Objective: The objective of this study is to evaluate the safety, efficacy, and owner satisfaction following electrosurgical ventriculocordectomy (EVC), in conjunction with prosthetic laryngoplasty, in equine clinical cases affected with left- or right-sided recurrent laryngeal neuropathy.Methods: Retrospective data analysis of clinical signalment, surgery, athletic outcome, intra- and postoperative complications, and postoperative examinations from clinical cases wherein EVC was performed in conjunction with traditional prosthetic laryngoplasty from one practice. Owners were contacted by phone or email for a follow-up questionnaire.Results: Twenty-four horses underwent unilateral EVC, performed transendoscopically under sedated restraint, using monopolar electrosurgical instrumentation successfully. One horse experienced excessive intraoperative hemorrhage. No horses demonstrated postoperative complications. Twenty cases had a history of increased airway noise prior to surgery. In 15 of these cases (15/20, 75%), the airway noise was reported as fully improved post-surgery. Eighteen cases had a history of exercise intolerance prior to surgery. In 15 of these cases (15/18; 83%), the exercise intolerance was reported as resolved.Conclusion: EVC, in conjunction with prosthetic laryngoplasty, can contribute to improvement of RLN symptoms and aid in the effective return to athletic work. Performing transendoscopic ventriculocordectomy with monopolar electrosurgical instrumentation provides comparable clinical outcomes to traditional techniques using a diode laser or direct excision via laryngotomy.

Thyrohyoideus muscle innervation in the horse.

To describe the innervation of the thyrohyoideus (TH) muscle and to confirm our findings with stimulation of first cervical (C1) nerve branches. Ex vivo phase 1 and clinical phase 2. Fourteen head and neck specimens and 17 client-owned horses. In phase 1, the cranial nerve (CN) XII and the C1 nerve were dissected with their branches in 20 dissections were performed on 14 specimens (6 left and right side and 8 only left or right) Anatomy was noted. Samples of nerve bifurcations were collected for histological confirmation of anatomical findings. First cervical nerve branches were stimulated in horses undergoing cervical nerve graft to treat laryngeal hemiplegia. The nerve innervating the TH muscle arose directly from the C1 nerve in 17 of 20 dissections, from an anastomotic branch between CN XII and the C1 nerve in two of 20 dissections, and from the C1 nerve and the anastomotic branch in one of 20 dissections. No direct connection between the TH muscle and CN XII was found. Histological examination revealed that the anastomosis was composed of C1 nerve fibers passing over to CN XII. First cervical stimulation resulted in TH muscle contraction in 16 of 17 horses. The innervation of the TH muscle originated from the C1 nerve according to dissection, histological, and conduction studies, with variation in the branching pattern. Care should be taken to preserve the C1 nerve during prosthetic laryngoplasty. The surgical technique for C1 nerve grafts should be reconsidered in light of these findings, along with new options to treat dorsal displacement of the soft palate..

Ultrasonographic findings post laryngoplasty in the horse.

Laryngoplasty is commonly used to treat laryngeal hemiplegia in Thoroughbred racehorses. Evaluation of the success of the laryngoplasty is traditionally determined using endoscopy. Laryngeal ultrasonography and normal ultrasonographic appearance have been reported in the standing horse, but post-laryngoplasty and ventriculectomy ultrasonographic evaluation has limited literature coverage. A prospective case series of 10 Thoroughbred racehorses with left laryngeal hemiplegia was examined ultrasonographically and endoscopically prior to 3-10 days, 30-50 days, and 6-12 months after laryngoplasty and ventriculectomy. Anatomical structures and Plica vocalis movements were described and measurements and gradings analyzed by repeated means analysis of variance (P<.05). Postsurgical ultrasonographic visualization of Ventriculus laryngis entrances was possible. The distance between Plica vocalis in exhalation was significantly larger than that during inhalation (P<.05). Pre- and postsurgical caudal Basihyoideum and rostral Cartilago thyroidea depth was significantly different in some instances (P<.05). No significant differences in the Muscularis cricoarytenoideus lateralis measurements were found. Complications in the extra-luminal structures were found in seven horses including soft tissue swelling, seroma, and hematoma. A luminal Plica vocalis abscess and Plica vocalis granuloma were also detected ultrasonographically. Ultrasonography can be used to evaluate the post-laryngoplasty horse for assessing the success of the procedure, monitoring healing, and detecting complications.

RELATO DE CASO: LARINGOPLASTIA SEGUIDA DE VENTRICULECTOMIA EM EQUINO HEMIPLÉGICO

Among the frequent affections that affect the respiratory system of racehorses, laryngeal hemiplegia is considered the main of these pathologies, which is characterized by the collapse of the arytenoid cartilage, resulting from a progressive distal degenerative axonopathy of the recurrent laryngeal nerves, the left being more commonly affected, with breathing noises during exercise, dyspnea and loss of athletic performance. The present work reports a case of surgical correction of laryngeal hemiplegia in a horse racing English horse, the animal presented progressive loss of performance in running, dyspnea and exacerbation of respiratory sounds, endoscopy of the upper airways was performed as a method confirmatory diagnosis of the disease and the therapeutic approach was based on a laryngoplasty using the Tie Back technique followed by a Ventriculectomy maneuver. After the postoperative period, the animal showed complete remission of the condition, returning to its normal sports performance.

Гемиплегия гортани у спортивных лошадей: последние достижения и положение на сегодняшний день

Laryngeal hemiplegia today is one of the most common pathologies of the upper respiratory tract of large breed sports horses and can greatly affect the performance of an animal and its athletic career. This article reviews the latest research data on the nature of this disease, aetiology, pathogenesis and classification, the genetic susceptibility of large horses to this pathology, the method of minimally invasive diagnosis, and the method of treatment of this disease, which is currently the most effective.

Laryngeale hemiplegie bij het paard: een update

Laryngeale hemiplegie is een bekende aandoening van de bovenste luchtwegen bij het paard. Het komt niet alleen voor bij volbloeden maar eveneens bij warmbloedpaarden, koudbloeden en pony’s. Deze aandoening wordt voornamelijk aan de linkerzijde gezien. De functie van de linker nervus laryngeus recurrens wordt geïnhibeerd, waardoor een verlamming van de linker cricoarythenoïdeus dorsalis-spier optreedt. Laryngeale hemiplegie aan de rechterzijde heeft bijna altijd een onderliggende oorzaak in tegenstelling tot laryngeale hemiplegie aan de linkerzijde. Deze aandoening geeft mogelijk aanleiding tot een vermindering van het prestatievermogen van het paard, maar vaak is de primaire klacht die de eigenaar waarneemt de aanwezigheid van een inspiratoir geluid. De diagnose is niet altijd simpel, voornamelijk omdat de meeste praktijkdierenartsen geen endoscoop ter beschikking hebben. Recente studies wijzen uit dat echografisch onderzoek van de larynx kan helpen bij de diagnose van deze aandoening. Dit is een goed en beter beschikbaar alternatief. Indien de enige klacht die de eigenaar waarneemt het geluid is dat het paard maakt tijdens de arbeid, dan is een laserbehandeling de beste keuze. Ondervindt het paard problemen met de intensiteit van het werk dan is verdere chirurgische interventie nodig. Laryngoplastie of “tie-back” krijgt tegenwoordig nog steeds de voorkeur van de meeste chirurgen. Er zijn echter nieuwe behandelingen in ontwikkeling, waarbij gebruik wordt gemaakt van zenuwgreffes en pacemakers om reïnnervatie mogelijk te maken. Deze laatste vernieuwingen zorgen voor een sterke reductie van de complicaties die wel vaker gezien worden bij laryngoplastie. Niettegenstaande is de prognose voor sportpaarden met idiopathische linker laryngeale hemiplegie die een laryngoplastie ondergaan zonder postoperatieve complicaties, goed.

Trans-endoscopic ventriculocordectomy in horses using monopolar electrocautery

Laryngeal hemiplegia is one of the most common upper airway affections in horses. Laringoplasty is indicated in high-performance animals, and when the only complaint is noisy breathing, ventriculectomy and cordectomy can be performed. This study aimed to establish a minimally invasive surgical approach to ventriculocordectomy in horses, through a videoendoscopic procedure. The technique was developed in two stages, the first one was a cadaveric study and the second one was in vivo, both using two flexible endoscopes. A bilateral ventriculocordectomy was performed in two cadavers, totaling the removal of four vocal cords. In the second stage, a left unilateral ventriculocordectomy was performed in three animals with laryngeal hemiplegia. The vocal cords were pulled by one of the endoscopes with 3.2mm grasping forceps, while the second equipment was used for the resection of vocal cords with a flexible electrode adapted for monopolar electrosurgery (electrocautery). The average time for removal of the vocal cords was 23±5 minutes. In the postoperative care, moderate inflammation around the surgical wound was observed, with complete healing in 21 days in one horse and 28 days in the other two. One animal presented exuberant granulation tissue on the surgical site. Other complications due to the tested technique were not noticed; therefore, it could be a less invasive option for ventriculocordectomy in horses. The developed technique proved to be effective for ventriculocordectomy execution in horses. The main advantages of this approach were reduced surgical time, shorter healing average time, no need for daily dressings and return to normal activities in a shorter period when compared to other surgical approaches. The limitation of the technique consists of the need for two endoscopes for its accomplishment. Further studies, with more animals, are needed to improve the technique.