Partial laryngectomy for the management of laryngeal masses in six cats

Abstract

Objectives: Partial laryngectomy is an organ-sparing surgical procedure for the removal of laryngeal masses which has not been described in cats. The aim of this study was to report on the surgical procedure and the short- and long-term clinical outcomes of cats that underwent partial laryngectomy.

Methods: Medical records were retrospectively collected over a 4-year period in two institutions. The following data were retrieved: signalment, history, clinical signs, diagnostic test results, surgical procedure, postoperative management, complications and outcome.

Results: Six cats underwent partial laryngectomy. The most common clinical signs in cats with laryngeal masses were stridor (n = 4) and dyspnoea (n = 4). In all cats, a full-thickness portion of one or several laryngeal cartilages was resected, including thyroid cartilage alone (n = 2), thyroid cartilage and arytenoid (n = 2), and arytenoid cartilage and epiglottis (n = 2). The resected laryngeal masses were reported to be lymphoma (n = 3), carcinoma (n = 1), laryngeal cyst (n = 1) and inflammatory laryngeal disease (n = 1). All cats survived the surgical intervention of partial laryngectomy. Four cats showed varying degrees of respiratory distress in the short-term postoperative period. A temporary tracheostomy tube was placed in two cats. No other postoperative complications were noted in the short- or long-term. Four cats were still alive at the time of writing. These cats survived at least 252 days.

Conclusions and relevance: In a small number of cases, our results show that successful long-term outcomes after partial laryngectomy are achievable, with longer survival times than previously reported. Therefore, partial laryngectomy should be considered as a viable treatment option in cats with laryngeal masses.

Keywords: Partial laryngectomy; laryngeal disease; laryngeal mass; laryngeal neoplasia; larynx.

Figure 1

Transoral view of the laryngeal mass (arrows) in cat 1. SP = soft palate; E = epiglottis

Figure 2

(a) Ventral approach to the larynx. The cranial border of the thyroid cartilage was palpated and elevated (Debakey forceps) before being incised in the midline. (b) The thyroid cartilage was incised on its ventral midline and kept open with stay sutures. *Basihyoid bone; cr = cranial; cd = caudal; SH = sternohyoid muscle; TH = thyroid cartilage; THM = thyrohyoid muscle; CL = cricothyroid ligament; CT = cricothyroid muscle

Figure 3

(a) The laryngeal mass (arrows) was exposed and elevated with additional stay sutures; (b) aspect of the larynx after resection of the mass. Portions of the thyroid and arytenoid cartilage were resected. *Basihyoid bone; cr = cranial; cd = caudal; SH = sternohyoid muscle; TH = thyroid cartilage; A = arytenoid cartilage; P = dorsal pharyngeal wall; V = vocal cord

Figure 4

The defect in the thyroid cartilage was reconstructed with a muscular patch (right sternohyoid muscle). *Basihyoid bone; cr = cranial; cd = caudal; SH = sternohyoid muscle; rSH = right sternohyoid muscle