To describe a modified laryngeal tie-forward procedure (LTFP) using metallic implants.

Study Design

Retrospective case series.


Twenty-seven horses (including 24 race horses) with dorsal displacement of the soft palate (DDSP) or palatal instability (PI) diagnosed using high-speed treadmill endoscopy (n = 15), history and resting examination (n = 8), or dynamic endoscopy over ground (n = 4).


All horses underwent the modified LTFP. Modifications of the surgical procedure consisted in the use of 3 metallic stents called Suture ButtonTM through which the sutures are threaded and in a tying technique that involved a single knot connecting left and right suture loops (versus tying each separately). Lateral radiographs were taken 24 hours after surgery. Follow-up was obtained by telephone communication with trainers or owners.


Surgery was performed without complications on all horses. The 3 metallic buttons were clearly visible on the postoperative radiographic examination. No evidence of suture breakage was observed 24 hours postoperatively based on radiographs.


In other aspects, this technique is not very different from that originally described by Ducharme et al; it is an innovation that could offer some advantages to the surgeons and increase suture resistance to pullout from the thyroid cartilage. Our technique was used without complication in a small group of horses and return to performance may be similar to the original technique.