Evaluation of the airway mechanics of modified toggle laryngoplasty constructs using a vacuum chamber airflow model. Issue 7 (26th July 2021) - Gray, Sarah M.
Abstract: Objective: To evaluate the airway mechanics of modified toggle LP constructs in an airflow chamber model and compare these to the airway mechanics of standard LP constructs. Study design: Ex‐vivo experimental study. Sample population: Fifty‐one equine cadaveric larynges. Methods: Bilateral LP constructs were performed using a modified toggle ( n = 23) or a standard ( n = 21) LP technique. Constructs were tested in an airflow model before and after cyclic loading which was designed to mimic postoperative swallowing. The cross‐sectional area (CSA), peak translaryngeal airflow (L/s), and impedance (cmH2 0/L/s) were determined and compared between LP constructs before and after cycling. Results: The mean CSA of the rima glottidis of the modified toggle LP constructs was 15.2 ± 2.6 cm 2 before and 14.7 ± 2.6 cm 2 after cyclic loading, and the mean CSA of the rima glottidis of the standard LP constructs was 16.4 ± 2.9 cm 2 before and 15.7 ± 2.8 cm 2 after cyclic loading. The modified toggle LP constructs had similar peak translaryngeal impedance before and after cyclic loading ( p = .13); however, the standard LP constructs had higher peak translaryngeal impedance after cyclic loading ( p = .02). Conclusion: The modified toggle and standard LP constructs had comparable airway mechanics in an ex‐vivo model. Clinical significance: Further investigation is warranted to determine the extent to which the modified toggle LP technique restores normal airway function in horses with RLN.