In vitro mechanical evaluation of equine laryngeal tie-forward constructs prepared with different suture materials and placement patterns.

Abstract

OBJECTIVE: To compare the mechanical properties of laryngeal tie-forward (LTF) constructs prepared with different suture materials and suture placement patterns during single load to failure testing. SAMPLE: Larynges harvested from 50 horse cadavers and 5 intact horse cadavers. PROCEDURES: In vitro LTF constructs were created by a standard technique with polyester sutures, a standard technique with polyethylene sutures, a modified technique with metallic implants and polyester sutures, a modified technique with metallic implants and polyethylene sutures, or a modified tie-off technique with polyester sutures (10 of each type of construct). Mechanical properties including maximal load (N) at failure and failure mode were compared among constructs. Also, maximal loads at failure of the in vitro LTF constructs were compared with the loads exerted on the sutures tightened to achieve rostral laryngeal advancement in intact cadavers. RESULTS: Constructs prepared by a standard technique with polyethylene sutures had a significantly higher pull out strength than those prepared by a modified technique with metallic implants and either polyester or polyethylene sutures. For constructs prepared by a standard technique with polyethylene sutures or similarly placed polyester sutures, maximal load at failure did not differ but the failure mode did differ significantly. The load to failure for all in vitro constructs was higher than the maximal load measured during a range of motion test in intact horse cadavers. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that LTF procedures can be performed in live horses with any of the suture materials and techniques tested.