A way to improve or resolve a condition or diagnosis. This might include resolving the underlying cause or treating the signs of disease (symptomatic treatment).

Cost: $1,000 to $2,500

These cost ranges are approximate and may vary from region to region.
Additional charges may also apply.

YOUR VET MAY Recommend

Laryngoplasty, Tieback Surgery

Cost: $1,000 to $2,500

These cost ranges are approximate and may vary from region to region.
Additional charges may also apply.


This is a commonly performed operation for "roarers"- horses diagnosed with laryngeal hemiplegia. In this condition, the muscle that is normally responsible for opening (abducting) the left arytenoid cartilage has lost its nerve supply, does not function, and may waste away, allowing the cartilage and vocal fold to collapse and obstruct airflow.

In this operation, large, heavy, non-absorbable suture material placed on the outside and to the rear of the larynx is used to mimic the pull of that muscle, to pull the arytenoid cartilage out of the airway and increase air flow through the larynx.

In some cases, this procedure may be combined with ventriculectomy, the removal of small sacs of tissues adjacent to the vocal cord.


The horse will need to be rested for a specific period of time, as recommended by the surgeon. Following this procedure, you will need to monitor the surgical site for several weeks and depending upon the specific procedure, you may need to keep the wound clean. Some surgeons recommend the use of throat sprays in cases where the larynx is opened.

my vet's role


In the normal swallowing reflex, the larynx closes. After this surgery, the larynx remains at least partially open and unprotected from food. Due to this, the most important potential side effect is aspiration, feed and dust getting into the windpipe resulting in chronic coughing. In some cases inflammation and pneumonia may also result.

The large suture may break, causing failure of the procedure.

Local swelling and infection of the surgery site, seroma formation.

In rare cases, the cartilage becomes chronically irflammed, resulting in arytenoid chondritis that obstructs air flow.

In some cases, the procedure does not help enough to allow a horse to return to a high level of function. This is especially true for flat racing horses that have the greatest demand for airflow.


Laryngoplasty should be reserved for severe cases of laryngeal hemiplegia. It should not be used in cases that can be managed more conservatively because of the potential complications and side effects.

Many pleasure horses may have breathing-related noise but do not require surgery.

your role

Is it working? Timeframe for effect.
Horses are rested for 4-6 weeks following the procedure and usually returned to work at 45-60 days.

Improvement in air flow is effective immediately after the surgery. Coughing should be minimal and gradually decrease with time.
Questions To Ask Your Vet:
  • Is this the best approach to improve my horse's performance & decrease roaring?
  • Are there procedures that can be performed standing or with surgical laser?
  • What is the likelihood of complications?
  • How frequently do you perform this surgery?
  • How does the outcome & complications associated with this surgery compare to other options?

further reading & resources

Related References:

Higgins AJ, Snyder JR eds. The Equine Manual. 2nd Ed. Edinburgh: Elsevier Saunders 2006.

Author: Doug Thal DVM Dipl. ABVP