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Rationale for use of the TSD device
as a treatment for DDSP

The TSD (Throat Support Device) is the outcome of over a decade of research conducted at Cornell University’s Equine Performance Testing Clinic designed to better understand the cause of dorsal displacement of the soft palate (DDSP).  There are many causes of DDSP.  Those with underlying intrinsic nasopharyngeal abnormalities such as subepiglottic or palatal cyst, mass or granuloma, aryepiglottic entrapment or nasopharyngeal inflammatory disease should be managed by established medical or surgical therapies. 

Recent studies at Cornell however indicate that DDSP is typically a functional problem rather than an anatomical problem leading to a series of experiments that focused on factors that could affect the relationships of the palate, larynx and hyoid appartus during high speed exercise.  Ultimately, it was discovered that surgical resection of the thyrohyoideus (TH) muscle in experimental horses leads to displacement that is virtually identical to clinical DDSP during exercise.  We thus believe that a deficit in TH function contributes to DDSP in most horses. 

The TSD is intended to mimic the effect of contraction of the TH muscle.  Other in vivo studies determined that contraction of the TH muscle moves the larynx into a more rostral and dorsal position.  The TSD collar is designed to mimic this effect.  High speed treadmill studies on both experimental horses and naturally occurring cases of DDSP indicate that the TSD collar is effective in prevention of DDSP.  Trainers and veterinarians using this device in racehorses have been very positive about their experiences.

 

 

The veterinarian's role in fitting the TSD device

  The TSD is a medical device and we believe that veterinarians should be involved in the selection of appropriate patients as well as working with trainers to ensure its proper fitting and use.  The TSD can be used to confirm the diagnosis of DDSP in suspect cases, as a primary treatment for DDSP, or as adjunctive therapy in cases following surgery for DDSP.

Please carefully review the "Instructions" section of this website, especially the video describing application of the TSD. Trainers will likely need assistance in identifying the basihyoid bone, a key landmark for proper fitting of the TSD and in understanding that the role of the TSD is to move the larynx forward.  If desired, you may use an endoscope during initial fitting to ensure that the collar is properly adjusted and exerting its desired effect.

The following video shows the expected rostrodorsal movement of the larynx as the Figure-8 component of TSD collar is alternately tightened and loosened.  The larynx should remain in this rostrodorsal position when the TSD is placed and should remain in this position as the head is extended.

High speed connection (5.5 Mb) (Quicktime)
Low speed connection (870 Kb) (Windows Media File)

 

 

References

 
  Woodie JB, Ducharme NG, Hackett RP, Erb HN, Mitchell LM, Soderholm LV:  Can an external device prevent dorsal displacement of the soft palate during strenuous exercise?  Equine Vet J. 2005 Sep;37(5):425-9.

Ducharme NG, Hackett RP, Woodie JB, Dykes N, Erb HN, Mitchell LM, Soderholm LV: Investigations into the role of the thyrohyoid muscles in the pathogenesis of dorsal displacement of the soft palate in horses.  Equine Vet J. 2003 May;35(3):258-63.

Woodie JB, Ducharme NG, Hackett RP, Erb HN, Mitchell LM, Soderholm LV. The effects of a laryngohyoid stabilizer on prevention of experimentally created dorsal displacement of the soft palate in exercising horses. (Abstract) Vet Surg 2003;32:500.