NAVLE Respiratory

Equine Laryngeal Hemiplegia Study Guide

Laryngeal hemiplegia, also known as recurrent laryngeal neuropathy (RLN) or colloquially as "roaring," is a progressive degenerative neuropathy of the recurrent laryngeal nerve that results in dysfunction of the cricoarytenoideus dorsalis (CAD)...

Overview and Clinical Importance

Laryngeal hemiplegia, also known as recurrent laryngeal neuropathy (RLN) or colloquially as "roaring," is a progressive degenerative neuropathy of the recurrent laryngeal nerve that results in dysfunction of the cricoarytenoideus dorsalis (CAD) muscle. This condition is one of the most common causes of upper airway obstruction and exercise intolerance in performance horses, particularly affecting Thoroughbreds and draft breeds.

The disease predominantly affects the left side (greater than 95% of idiopathic cases) due to the longer course of the left recurrent laryngeal nerve, which loops around the aortic arch before ascending to the larynx. This extended pathway makes the nerve more susceptible to axonal degeneration.

High-YieldOn the NAVLE, when you see a tall horse (especially Thoroughbred or Draft breed) with inspiratory noise during exercise and exercise intolerance, think laryngeal hemiplegia first. The left side is almost always affected in idiopathic cases.
Structure Function and Clinical Relevance
Arytenoid Cartilages Paired triangular cartilages; abduct during inspiration to open the rima glottidis; paralysis causes airway obstruction
Cricoid Cartilage Complete ring; anchoring point for prosthetic laryngoplasty sutures
Thyroid Cartilage Largest cartilage; forms lateral walls of larynx; surgical landmark
Epiglottis Elastic cartilage; protects airway during swallowing; can be affected by entrapment
Vocal Folds Form part of glottis; collapse with arytenoid dysfunction; may be removed during ventriculocordectomy

Anatomy and Neuroanatomy

Laryngeal Cartilages

The equine larynx is composed of several cartilages that work together to regulate airflow and protect the airway during swallowing. The arytenoid cartilages are paired, triangular-shaped hyaline cartilages that are the key structures affected in laryngeal hemiplegia. They articulate with the cricoid cartilage via the cricoarytenoid joint, which allows abduction and adduction movements critical for airway control.

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