Optimal Tension, Position, and Number of Prostheses Required for Maximum Rima Glottidis Area After Laryngoplasty

Objectives To evaluate the effect of 3 laryngeal prostheses alone or in combination on rima glottidis area in horses. Study Design Experimental randomized design. Sample Population Cadaveric equine larynges (n=22). Methods Three prostheses were preplaced in each of 14 larynges. Rima glottidis area was measured after loading each suture in 5Newton (N) increments from 0N to 35N. In 8 larynges, the 3 prostheses were tied alone or in combination at a fixed load of 15N and rima glottidis area measured. Results Rima glottidis cross-sectional area increased as the load on each prosthesis increased with maximum area reached at 20N for each prosthesis. At a fixed load of 15N, tying 2 and 3 prostheses in combination resulted in a larger rima glottidis cross-sectional area than achieved with each prosthesis alone. Conclusions A combination of 2 or 3 prostheses tied at a fixed load of 15N optimized rima glottidis cross-sectional area irrespective of the anatomic location of the prosthesis.