A procedure to correct a paralyzed larynx has fewer risks if it’s performed in a standing, sedated horse with the aid of local anesthesia, French researchers have learned.

Equine surgeons typically perform laryngoplasty, a surgery that reinforces paralyzed vocal folds and repositions paralyzed laryngeal cartilage, in anesthetized horses lying on their sides or backs. But new studies show that surgeons can do the same operation—also called “tie-back” surgery—on standing horses with local anesthesia. And the results seem better for both horse and owner, especially for very large sport horses, said Fabrice Rossignol, PhD, DVM, Dipl. ECVS, equine surgery specialist at the Grosbois Equine Clinic, in Boissy Saint Léger.

“Anatomically, everything falls into its correct position when the horse is standing erect, so it makes our intervention far more precise,” Rossignol said.

In the larynx, a small pair of pyramid-shaped cartilage structures (the arytenoid cartilages) and the vocal folds open (abduct) and close (adduct) to allow for breathing, swallowing, and vocalization. Sometimes, however, one of these cartilages (usually the left one) can become paralyzed, in a condition known as recurrent laryngeal neuropathy (RLN). Affected horses often have noisy breathing—also called “roaring”—and reduced performance