Diagnosis of laryngeal dysplasia in five horses using magnetic resonance imaging and ultrasonography

Summary Reasons for performing study: Laryngeal dysplasia due to suspected maldevelopment of the fourth branchial arch has been reported previously in the horse and has been associated with rostral displacement of the palatopharyngeal arch and/or right laryngeal dysfunction. These studies all described the endoscopic and/or anatomical post mortem identification of the disease, but ultrasonography or magnetic resonance imaging (MRI) of this disease have not been described. Hypothesis: MRI and ultrasound findings accurately reflect the anatomical features of presumptive fourth branchial arch abnormality and allow accurate ante mortem diagnosis of this condition and, therefore, appropriate management. Methods: Between February 2008 and January 2009, all horses examined at Rood and Riddle Equine Hospital diagnosed with rostral displacement of the palatopharyngeal arch and/or right laryngeal dysfunction using upper airway endoscopy (n = 5) underwent ultrasonography and MRI of the laryngeal region. Results: All 5 horses that met the inclusion criteria were identified and all underwent laryngeal MRI and ultrasound examinations. Features consistent with laryngeal dysplasia, including lack of the cricothyroid articulation, dorsal extension of the thyroid cartilage lamina, and absence or hypoplasia of the cricopharyngeus muscle, were seen in all cases using both types of imaging. Conclusions and potential relevance: MRI and ultrasonography permit definitive premortem diagnosis of laryngeal dysplasia. Upper airway abnormalities identified using endoscopy can be more fully characterised using MRI and ultrasonography allowing more appropriate recommendations to be made. Preoperative imaging may also prevent inappropriate surgical intervention.