Equis ISSN 2398-2977

Larynx: arytenoid chondritis

Synonym(s): Arytenoid granuloma

Contributor(s): Patrick Colahan, Paddy Dixon, Nicola Menzies-Gow

Introduction

  • Inflammatory/infectious/dystrophic changes of one or both arytenoid cartilages most commonly seen in young Thoroughbred horses.
  • Cause: unknown although iatrogenic trauma and respiratory tract infection implicated.
  • Signs: may be asymptomatic in non-athletes; decreased exercise tolerance and inspiratory stridor; dyspnea at rest in severe cases.
  • Diagnosis: history, clinical signs and direct endoscopic visualization.
  • Treatment: surgical debridement, removal of affected cartilage and systemic antibiosis.
  • Prognosis: moderate chance of return to racing if unilateral arytenoidectomy performed but poor if severe bilateral involvement.

Pathogenesis

Etiology

  • The precise etiology of arytenoid chondritis is unknown, but it is suspected to be secondary to mucosal trauma leading to a viral or bacterial infection that progresses to involve the arytenoid cartilage.
  • Implicated causes are racing on dirt/sand - inhaled during fast work - and respiratory tract infections Lung: pneumonia - bacterial.

Predisposing factors

Specific

  • Mucosal trauma.
  • Viral or bacterial respiratory infection.

Pathophysiology

  • One or both arytenoid cartilages involved.
  • The body of the arytenoid cartilage is most commonly affected, but the corniculate process may be involved as well.
  • Dystrophic changes → enlargement, inflammation, mineralization, necrosis of central portion of cartilage and formation of purulent sinus tract with granulation tissue which protrudes into the airway.
  • Arytenoid chondritis → loss of arytenoid abduction → reduction in laryngeal luminal diameter → restricted airflow → reduced exercise capacity and inspiratory stridor at speed.
  • The immobility may result from perilaryngeal swelling or neuropathy secondary to inflammation.
  • This condition is progressive in nature.
  • Pharyngeal and peripharyngeal abscesses and nasopharyngeal strictures may arise from arytenoid corniculate chondritis.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Garrett K S, Embertson R M, Gardner I A, MacLachlan N J & Guthrie A J (2013) Ultrasound features of arytenoid chondritis in Thoroughbred horses. Equine Vet J 45 (5), 598-603 PubMed.
  • Strand Eet al (2012) Relative prevalence of upper respiratory tract obstructive disorders in two breeds of harness racehorses (185 cases: 1998-2006). Equine Vet J 44 (5), 518-523 PubMed.
  • MacLean A A & Robertson-Smith R G (1984) Chronic chondritis of the arytenoid cartilages in a pony mare.  Aust Vet J  61 (1), 27-28 PubMed.
  • Haynes P F, Snider T G, McClure J R & McClure J J (1980) Chronic chondritis of the equine arytenoid cartilage.  JAVMA  177 (11), 1135-1142 PubMed.

Other sources of information

  • Parente E J, Tulleners E & Southwood L L (2003) Partial Arytenoidectomy for Treatment of Failed Laryngoplasty or Arytenoid Chondritis. In: Proc 49th AAEP Convention. pp 373-376.


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