A comparison of the effects of unilateral thyroarytenoid lateralization versus cricoarytenoid laryngoplasty on the area of the rima glottidis and clinical outcome in dogs with laryngeal paralysis

Objective - To compare the clinical effects of unilateral thyroarytenoid lateralization versus unilateral cricoarytenoid laryngoplasty for the treatment of canine laryngeal paralysis. Study Design - A prospective, clinical trial. Animals - Twenty client-owned dogs admitted to Glasgow University Veterinary Hospital (GUVH) between 1997 and 1999 with a diagnosis of laryngeal paralysis. Methods - A thorough evaluation of each dog was undertaken that included history, physical and neurologic examinations, complete blood count, serum biochemistry profile, serum thyroxine (T₄) level, and thyroid-stimulating hormone (TSH) assay. The exercise tolerance of each dog was investigated by assessing respiratory rate and arterial blood gas analysis at rest and after 5 minutes of mild exercise. Animals were included in the study on the basis of a definitive diagnosis of laryngeal paralysis made by endoscopic observation of the larynx in the lightly anesthetized patient. The animals were randomly assigned to 1 of 2 treatment groups: unilateral thyroarytenoid lateralization or unilateral cricoarytenoid laryngoplasty, with all procedures being performed by the same surgeon. Video images of the rima glottidis were recorded pre-and postoperatively using video endoscopy. Video images were digitized and the area of the rima glottidis measured using image-analysis software. An increase in the area of the rima glottidis was expressed as a percentage of the preoperative area. All animals were reassessed 6 weeks' postoperatively, and exercise tolerance tests were repeated. Results - The mean increase in the area of the rima glottidis postoperatively when compared with the preoperative area was 140% for those animals undergoing unilateral thyroarytenoid lateralization (range, 120%-158%) and 207% for those animals undergoing unilateral cricoarytenoid laryngoplasty (range, 183%-228%). This difference was statistically significant (P < .0001). At the 6-week postoperative examination, there was no significant difference in improvement between the 2 groups when compared on either a clinical basis or exercise tolerance tests. The mean surgical time in the 2 groups was 25 minutes for thyroarytenoid lateralization and 43 minutes for cricoarytenoid laryngoplasty. This was a statistically significant difference (P = .002). Conclusion - Although increase in area of the rima glottidis was significantly greater after unilateral cricoarytenoid laryngoplasty compared with unilateral thyroarytenoid lateralization, no difference in clinical outcome could be detected. However, the cricoarytenoid laryngoplasty procedure required significantly more surgical time. Clinical Relevance - Both unilateral cricoarytenoid laryngoplasty and unilateral thyroarytenoid lateralization are successful methods for the treatment of laryngeal paralysis; however, thyroarytenoid lateralization requires less surgical time to perform.