Many other causes may occasion temporary
Many other causes may occasion temporary, intermittent, or permanent noisy respiration, but chronic roaring is caused by paralysis of the muscles of the larynx; and almost invariably it is the muscles of the left side of the larynx that are affected.
In chronic roaring the noise is made when the air is drawn into the lungs; only when the disease is far advanced is a sound produced when the air is expelled, and even then it is not nearly so loud as during inspiration.
Fonte: Diseases of the Horse
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