Feasibility, repeatability, and safety of ultrasoundguided stimulation of the first cervical nerve at the alar foramen in horses.

OBJECTIVE: To develop and assess the feasibility, repeatability, and safety of an ultra sound- guided technique to stimulate the firs t cervical nerve (FCN) at the level of the alar foramen of the atlas of horses. ANIMALS: 4 equine cadavers and 6 clinically normal Standardbreds. PROCEDURES: In each cadaver, the FCN pathway was determined by dissection, and any anastomosis between the firs t and second cervical nerves was identified. Subsequently, each of 6 live horses underwent a bilateral ultrasound-guided stimulation of the FCN at the alar foramen 3 times at 3-week intervals. A fter each procedure, horses were examined daily for 5 days. RESULTS: In each cadaver, the FCN passed through the alar foramen; a communicating branch between the FCN and the accessory nerve and anastomoses between the ventral branches of the FCN and second cervical nerve were identified. The anastomoses were located in the upper th ird of the FCN pathway between the wing of the atlas and the nerve's entry in the omohyoideus muscle. Successful ultrasound-guided electrical stimulation was confirmed by twitching of the ipsilateral omohyoideus muscle in all 6 live horses; this finding was observed bilaterally during each of the 3 experimental sessions. Nocomplications developed at the site of stimulation. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that ultrasound-guided stimulation of the FCN at the alar foramen appears to be a safe and straightforward procedure in horses. The procedure may have potential for use in horses with naturally occurring recurrent laryngeal neuropathy to assess reinnervation after FCN transplantation or nerve-muscle pedicle implantation in the cricoarytenoideus dorsalis muscle. [ABSTRACT FROM AUTHOR]