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Ex vivo biomechanical stability of 5 cricoid‐suture constructs for equine laryngoplasty†

Objective: To determine the biomechanical properties of 5 suture constructs in the equine cricoid under cyclic loading and load to failure testing. Study design: Ex vivo study. Samples: Seventy‐five equine cadaver larynges. Methods: Each larynx was implanted with 1 of 5 cricoid‐suture constructs. The standard laryngoplasty, where a suture is passed once through the cricoid, including its caudal edge, was used in 2 constructs: 1 with 5 USP Ethibond (ES) and 1 with 2 mm Fibertape (FS). In the third construct, the 2 mm Fibertape was passed twice through the cricoid including its caudal edge (Double Loop—DL). Constructs 4 and 5 used 2 mm Fibertape in a U‐shaped loop passed through the cricoid but excluding its caudal edge. One construct was supported with a metallic button (MB) on the caudo‐ventral aspect of the cricoid while the other included only the U‐shaped loop (U). Constructs were subjected to cyclic loading and to single cycle to failure. Reduction of the left‐to‐right arytenoid angle quotient (LRQ), suture migration, and load at failure were compared. Results: LRQ reduction after cyclic loading was lower in MB and U than ES constructs. During cyclic loading, suture migration was reduced in MB, U, and DL compared to ES constructs. Mean load at failure was lower in FS and U than in ES constructs. Conclusion: Loss of abduction after equine laryngoplasty may be reduced and pullout forces increased by applying a MB construct in the cricoid cartilage. In vivo testing is required to verify these results.