Left: Endoscopic image of horse with a grade IV (complete paralysis) left laryngeal hemiplegia. Note that the right arytenoid is fully abducted while the left arytenoid hangs within the airway. Right: Endoscopic image of horse 24 hours after tie-back procedure. Note that the left arytenoid cartilage is maintained in abduction while the right arytenoid cartilage is imaged in a resting position.