Laryngeal tie-forward in horses with dorsal displacement of the soft palate

Taken from the article: Laryngeal tie-forward surgery is a successful treatment option for iDDSP in horses. Soft palate thermocautery does not appear to offer additional benefits.
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Overground endoscopic examination following laryngeal tie-forward in horses with dorsal displacement of the soft palate
Vet Surg. 2025 Mar 18. doi: 10.1111/vsu.14245. Online ahead of print.
Authors
Timothy P Barnett 1 , Victoria A Colgate 1 , Natalie Robinson 2 , Lewis C R Smith 1 , Lorraine Palmer 1 , Safia Z Barakzai 3
Affiliations

1 Rossdales Equine Hospital, Newmarket, UK.
2 VetPartners Ltd, York, UK.
3 Equine Surgical Referrals Ltd, Brighton, UK.

PMID: 40099351
DOI: 10.1111/vsu.14245

Abstract

Objectives: To compare overground endoscopy (OGE) findings and racing performance in horses before and after laryngeal tie-forward (LTF) surgery for the treatment of intermittent dorsal displacement of the soft palate (iDDSP).

Study design: Retrospective case series with follow up.

Animals: A total of 56 horses met the inclusion criteria.

Methods: Clinical record review of all horses definitively diagnosed with iDDSP, treated with LTF surgery, and evaluated with a single OGE examination postoperatively. In addition to LTF, some horses underwent bilateral aryepiglottic fold resection (AEFR) and/or soft palate thermocautery (SPTC). Overground endoscopy findings and racing performance metrics were compared preoperatively and postoperatively.

Results: There was a 75% reduction (p < .001, 95% CI: 64% to 86%) in the presence of iDDSP and a 23% reduction (p = .002, 95% CI: 10% to 36%) in the presence of palatal instability (PI) on OGE after LTF. Soft palate thermocautery was performed concurrently with LTF in 16 horses but they showed no additional reduction in prevalence of iDDSP after surgery. There was a 22% increase (p = .01, 95% CI: 5% to 38%) in the number of horses that raced and an 18% increase (p = .05, 95% CI: 1% to 35%) in those that were placed postsurgery. Horses reported to have suspected upper airway impairment postoperatively had higher odds of iDDSP on repeat OGE (OR: 11, 95% CI: 2-55). Conclusion: Seventy five percent of horses undergoing LTF had no evidence of iDDSP on postoperative OGE, and SPTC did not reduce the incidence further. Horses with reported suspected upper airway impairment postoperatively were more likely to have continued iDDSP. Clinical significance: Laryngeal tie-forward surgery is a successful treatment option for iDDSP in horses. Soft palate thermocautery does not appear to offer additional benefits. Reports of suspected ongoing upper airway impairment would warrant repeat OGE. © 2025 American College of Veterinary Surgeons.