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Topic:Guttural Pouch
The guttural pouch is a unique anatomical structure in horses, consisting of a pair of air-filled sacs located within the head. These sacs are extensions of the Eustachian tubes and are situated between the base of the skull and the atlas vertebra. The guttural pouch is involved in various physiological functions, including temperature regulation of blood traveling to the brain and possibly influencing auditory processes. Due to its location, the guttural pouch is susceptible to infections and diseases such as guttural pouch mycosis and empyema, which can have significant health implications for horses. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, function, and clinical aspects of the guttural pouch in equine health.
Treatment of acute epistaxis secondary to guttural pouch mycosis with transarterial nitinol vascular occlusion plugs in three equids. 2 horses and 1 pony were evaluated for right-sided (1 horse and the pony) and left-sided (1 horse) acute epistaxis of 1 day's to 1 month's duration. Results: Endoscopic examination of the 3 equids revealed that the hemorrhage originated from the right maxillary artery in 2 equids and from the left internal carotid artery in the third. Mycosis of the auditory tube diverticulum (guttural pouch) was detected in all 3 equids. Results: All 3 equids underwent surgery, and transarterial nitinol intravascular plugs were placed to occlude affected blood vessels. All equids survived for a long period (i...
Complications of surgery for diseases of the guttural pouch. Guttural pouch diseases pose serious challenges in diagnosis and treatment. Complications from treatment are common and often life-threatening, largely because the unique anatomy of the guttural pouches brings them into intimate contact with the nervous, respiratory, and cardiovascular systems. There is little forgiveness for surgical errors, and so the surgeon should focus on ways to anticipate and prevent them. As with any disease, errors in diagnosis can set the stage for many surgical errors and must be recognized. This article deals with errors that can be expected after the most common s...
Glycoprofile of the different cell types present in the mucosa of the horse guttural pouches. Histochemical characterization of the equine guttural pouches was performed using lectins combined with sialidase digestion and deglycosylation pre-treatments. The goblet cells contained O- and N-linked oligosaccharides with alpha-Fuc, GlcNAc moieties whereas beta-GalNAc, beta-Gal-(1-3)-GalNAc, beta-Gal-(1-4)-GlcNAc and alpha-Gal residues belonged only to O-linked glycoproteins. The acinar and ductal cells expressed alpha-Man/alpha-Glc in N-linked oligosaccharides, GlcNAc in both O- and N-glycoproteins and beta-GalNAc, beta-Gal-(1-3)-GalNAc, beta-Gal-(1-4)-GlcNAc and alpha-Gal residues include...
Differentiation of glycans in equine guttural pouches. The aim of this study was to investigate the carbohydrate composition of mucosubstances in the equine guttural pouches using conventional histochemical tests in conjunction with glycolytic digestion to degrade different classes of glycosoaminoglycans. In the goblet cells, the mucopolysaccharides contained chondroitin sulfate B, heparin, heparan sulfate and sialic acid residues. The acinar cells also expressed these substances (except for heparin), whereas the ductal cells produced chondroitin sulfate B and sialic acid. Neutral sugars were also found in each cell type. The diversity of the glyc...
Eustachian tube diverticulum chondroids and neck abscessation in a case of Streptococcus equi subsp. equi. A 12-year-old, grey, crossbred pony mare was presented with a swelling in the neck over the area of the 2nd cervical vertebra (C2), which was found to be painful on palpation. The neck was held stiffly. Radiography of the cervical region showed a focal area of increased radio-opacity over the dorsal, caudal and lateral aspect of the dorsal spinous process of C2. Ultrasound confirmed the presence of a hypoechoic area approximately 15 cm in diameter superimposed over the dorsal spinous process of C2. An aspirate was taken of the mass, which revealed purulent exudate confirming the diagnosis of a...
A surgical approach to the lateral compartment of the equine guttural pouch in the standing horse: modification of the forgotten “Garm technique”. The objective of this study was to evaluate the feasibility, efficacy and complications following lavage and drainage of the lateral compartment (LC) of the equine guttural pouch (GP) using a modified Garm's technique (MGT). In an ex vivo study (study 1), six cadaver heads were examined to assess the anatomical limits of the surgical approach and whether vital structures might be damaged. This was followed by an in vivo study (study 2) in which a lavage/drainage tube was placed for 3 days into each LC of four standing horses using the MGT. In both studies, the procedure offered direct access i...
Pharyngeal neuromuscular dysfunction associated with bilateral guttural pouch tympany in a foal. A 2-month-old warmblood filly was presented for a 1-week history of a large, nonpainful, fluctuant swelling of the parotid and laryngeal area. Bilateral guttural pouch tympany was diagnosed. Surgical correction resolved the guttural pouch tympany; however, postoperative pharyngeal neuromuscular dysfunction developed. Dysfonction pharyngée neuromusculaire associée à un tympanisme bilatéral des poches gutturales chez un poulain. Une pouliche de race Warmblood a été présentée pour examen d’une enflure marquée non-douloureuse et fluctuante, localisée dans la région laryngée et paroti...
Progression of mycosis of the auditory tube diverticulum (guttural pouch) after arterial occlusion in a horse with contralateral temporohyoid osteoarthropathy. A 6-year-old Appaloosa mare was examined because of inappetance, difficulty eating, and swelling and mucopurulent discharge in the right eye. Results: Results of a CBC and serum bio-chemical analysis revealed no important findings. Ophthalmologic examination revealed scarring and ulceration of the superficial layers of the cornea. Endoscopic examination of the upper portion of the respiratory tract and auditory tube diverticula (guttural pouches) revealed abnormal thickness of the right stylohyoid bone and a plaque suggestive of mycotic growth on the left internal carotid artery. Radiographic ...
Guttural pouches, brain temperature and exercise in horses. Selective brain cooling (SBC) is defined as the lowering of brain temperature below arterial blood temperature. Artiodactyls employ a carotid rete, an anatomical heat exchanger, to cool arterial blood shortly before it enters the brain. The survival advantage of this anatomy traditionally is believed to be a protection of brain tissue from heat injury, especially during exercise. Perissodactyls such as horses do not possess a carotid rete, and it has been proposed that their guttural pouches serve the heat-exchange function of the carotid rete by cooling the blood that traverses them, thus pro...
Standing surgical removal of inspissated guttural pouch exudate (chondroids) in ten horses. To report use of a modified Whitehouse approach in standing horses for management of inspissated guttural pouch empyema. Methods: Retrospective study. Methods: Adult horses (n=10) with guttural pouch empyema. Methods: Inspissated exudate in 1 or both guttural pouches was removed surgically through a modified Whitehouse approach, with the horses standing and sedated. Medical records of affected horses were reviewed to determine history; physical, endoscopic, and radiological examination findings; surgical technique; complications, and outcome. Results: All horses had purulent nasal discharge; 3...
Surgical treatment of extensive chondroid formation in the guttural pouch of a Warmblood horse. A Warmblood horse presented with a purulent nasal discharge that had failed to respond to antibiotic therapy. Radiography and endoscopy confirmed a large number of chondroid masses (over 200) in the left guttural pouch. Despite the large number of chondroids present, there was no external swelling evident. The masses were surgically removed via a hyovertebrotomy approach that provided excellent exposure, and no postoperative complications were encountered. Long term follow-up (3 years) confirmed a successful outcome.
Guttural pouch mycosis in a 6-month-old filly. A 6-month-old filly was presented with unilateral epistaxis. Based on clinical signs, endoscopic examination, and postmortem examination, guttural pouch mycosis was diagnosed. The young age of the filly and the fact that this was the 2nd diagnosis of guttural pouch mycosis on this farm was unusual. Mycose de la poche gutturale chez une pouliche de 6 mois. Une pouliche âgée de 6 mois a été présentée pour épistaxis unilatérale. En tenant compte des signes cliniques, de l’examen endoscopique et de l’examen post-mortem, un diagnostic de mycose de la poche gutturale a été posé. Le je...
[Aspergillus fumigatus in nasopharyngeal cavity of horses]. Aspergillus fumigatus is a cosmopolitan opportunistic fungal associated to rhinopharyngitis, sinusitis and guttural pouches infection with nasal discharges. All them are similar with Strangle's sign, the infectious disease produced by Streptococcus equi spp. The aim of this work was to detect A. fumigatus in healthy horses living in boxes and field. 226 nasopharyngeal swabbing samples were obtained by mycological routine. A. fumigatus was isolated in 26 (11.5%) horses.
Laser fenestration of the mesial septum for treatment of guttural pouch chondroids in a pony. To describe removal of guttural pouch chondroids through a laser fenestrated mesial septum in a pony with an obstructed pharyngeal ostium of the left guttural pouch. Methods: Case report. Methods: Pony. Methods: Transendoscopic laser neodymium:yttrium aluminum garnet (Nd:YAG) fenestration of the mesial guttural pouch septum was made by contact method (bare fiber, 15-25 W, exposure time 4 seconds). Dissected tissue was removed by transendoscopic monopolar electrosurgery (loop electrode, cutting blade) and multiple chondroids of varying size were removed from the left guttural pouch through the ...
Transarterial coil embolisation in 31 horses (1999-2002) with guttural pouch mycosis: a 2-year follow-up. There have been no previously published large case series describing short- and long-term outcome of transarterial coil embolisation (TCE) in horses with guttural pouch mycosis (GPM). Objective: To describe the clinical and surgical features of horses with GPM presented at the Veterinary School of Lyon during a 28 month period; and to evaluate immediate to long-term results of TCE as a treatment. Methods: Medical records of all horses with GPM treated with TCE between February 1999 and July 2002 were analysed. To be included in the study, no other surgical or medical treatment for the mycosis ...
Tracheal perforation managed by temporary tracheostomy in a horse. Tracheal trauma with resultant rupture is uncommonly reported in veterinary literature. We report the case of a 16-year-old Thoroughbred gelding that sustained a 1 cm longitudinal perforation of the dorsal tracheal membrane in the proximal cervical region. The horse subsequently developed dyspnoea due to acute upper respiratory obstruction secondary to severe emphysema of the guttural pouches. A temporary tracheostomy caudal to the site of tracheal perforation was performed under local anaesthesia. This procedure helped relieve the upper airway obstruction and aided resolution of the injury by...
Fungal isolation and identification in 21 cases of guttural pouch mycosis in horses (1998-2002). This aetiological study of guttural pouch mycosis (GPM) in the horse was based on the retrospective study of 21 horses brought into the National Veterinary School of Lyon (France) between 1998 and 2002. Biopsies were taken from the lesions caused by GPM during endoscopic examination. In 87% of the cases, direct examination gave positive results, whereas 43% of the cultures were found to be negative. The main fungi observed were Aspergillus fumigatus (in three cases), A. versicolor (in two cases, together with other fungi), and A. nidulans and A. niger (one case each). In six cases, the Aspergi...
Inheritance of guttural pouch tympany in the arabian horse. The objective of the present study was to analyze the mode of inheritance of guttural pouch tympany (GPT) using pedigrees of Arabian horses. Complex segregation analyses were employed to test for the significance of nongenetic transmission and for monogenic, polygenic, and mixed monogenic-polygenic modes of inheritance. Horses affected by GPT comprised 27 Arabian purebred foals. Of these 27 animals, 22 were patients at the Clinic for Horses, School of Veterinary Medicine Hannover, Hannover, Germany, between 1994 and 2001 and 5 Arabian foals were from stud farms. Information on the pedigrees of...
The mystery of fungal infection in the guttural pouches. Advances in the understanding of guttural pouch physiology and novel therapeutic approaches to mycotic infections in the horse are reviewed. It is suggested that the guttural pouches may contribute to the regulation of arterial blood temperature, cooling the circulation to the brain to below body temperature. Aspergillus spp. is the major organism found in a guttural pouch affected with mycosis but it is unclear why this agent becomes aggressive. Conventional therapy aims to prevent fatal haemorrhage and to treat any neurological lesions but it is desirable to try to prevent the disease. A tec...
Retrospective analysis of 50 cases of guttural pouch tympany in foals. Between 1994 and 2001, guttural pouch tympany was diagnosed in 51 foals; there were approximately three times as many fillies as colts, of Arabian, different German warmblood breeds and Western horse breeds. There were significantly more Arabian and paint horse foals than expected in comparison with the breed distribution of the foals hospitalised at the Clinic for Horses. The foals' breed and sex did not influence the age of onset, the type and severity of the clinical signs or the recurrence rate. A surgical laser technique was used on 50 of the foals; in 35 cases only one surgical treatment...
[Population genetic analysis of the heritability of gutteral pouch tympany in Arabian purebred foals]. The objective of the present study was to analyse the importance of the influences of the sex, inbreeding coefficient and the additive genetic contribution to the occurrence of guttural pouch tympany in Arabian foals. Horses affected by guttural pouch tympany were ascertained in the Clinic for Horses, School of Veterinary Medicine Hannover. The data comprised 27 Arabian purebred foals with guttural pouch tympany. Of these 27 animals 22 were patients of the Clinic for Horses between 1994 and 2001 and 5 Arabian foals were sampled on the studs. Information on the pedigrees of these patients allow...
Empyema of the guttural pouch (auditory tube diverticulum) in horses: 91 cases (1977-1997). To identify features of guttural pouch (auditory tube diverticulum) empyema in horses and compare findings of uncomplicated guttural pouch empyema with guttural pouch empyema complicated by chondroids. Methods: Retrospective study. Methods: 91 horses with guttural pouch empyema. Methods: Medical records of horses with guttural pouch empyema were reviewed. Results: The most common owner complaint and abnormal finding was persistent nasal discharge. Chondroids were detected in 21% (19/91) of affected horses. Streptococcus equi was isolated from the guttural pouch in 14 of 44 horses; for Streptoc...
[Gutteral pouch tympany in German warmblood foals: influence of sex, inbreeding and blood proportions of founding breeds as well as estimation of heritability]. The objective of the present study was to analyse the importance of the influences of sex, inbreeding coefficient, proportion of genes of the original breeds and the additive genetic contribution to the occurrence of guttural pouch tympany in foals belonging to German Warmblood breeds. Foals affected by guttural pouch tympany were ascertained in the Clinic of Horses, School of Veterinary Medicine Hannover. This data set comprised 22 German Warmblood foals with guttural pouch tympany, which were patients of the Clinic for Horses between 1994 and 2001. Information on the pedigrees and all availa...
Diseases of the guttural pouches. Guttural pouches are unique anatomic structures in Equidae. Conditions affecting the guttural pouches present with clinical signs that are not observed in other domestic species, and treatment of some of these conditions can be challenging. This article describes the anatomy and examination of the guttural pouches and reviews the presenting signs and treatment of the more common conditions affecting them, including empyema, tympany, mycosis, and stylohyoid arthropathy.
Temporohyoid osteoarthropathy in 33 horses (1993-2000). A retrospective study of the medical records of 33 horses was performed to determine the clinical and diagnostic abnormalities associated with temporohyoid osteoarthropathy. Data collected from medical records included signalment, presenting complaints, history, physical examination findings, laboratory data, results of diagnostic imaging studies, and treatments. Follow-up information was obtained from a review of case records; by telephone conversation with the owner, veterinarian, or trainer; or by both methods. Of 33 horses with temporohyoid osteoarthropathy, 29 presented with facial nerve ...
Cytological and microbiological findings in guttural pouch lavages of clinically normal horses with head restraint. To evaluate the cytological and microbiological contents of guttural pouch washes of ten randomly selected horses restrained so as to prevent them lowering their heads, and to assess the possible effects on the guttural pouch environment in these horses. Methods: Cytological and microbiological studies were performed on guttural pouch washes of ten clinically normal horses restrained in a standing position so as to prevent them from lowering their heads below normal, as would happen during transportation on long journeys. They were restrained for 12 or 24 h and cytological, bacteriological and...
M cells and associated lymphoid tissue of the equine nasopharyngeal tonsil. The aim of this study was to characterise the morphological and histochemical features of equine nasopharyngeal tonsillar tissue. Nasal and oropharyngeal tonsillar tissue has been described as the gatekeeper to mucosal immunity because of its strategic location at the entrance to the respiratory and alimentary tracts. A combination of light, scanning and transmission electron microscopy has revealed the presence of follicle-associated epithelium (FAE) overlying lymphoid tissue of the equine nasopharyngeal tonsil caudal to the pharyngeal opening of the guttural pouch. Membranous microvillus (M)...
Fistulation of the auditory tube diverticulum (guttural pouch) with a neodymium:yttrium-aluminum-garnet laser for treatment of chronic empyema in two horses. Two horses with chronic empyema of the auditory tube diverticulum (guttural pouch) were refractory to medical treatment; empyema was bilateral in 1 horse and unilateral in the other. Both horses were treated by fistulation of the cartilage of the pharyngeal orifice by use of a neodymium:yttrium-aluminum-garnet laser in a noncontact manner. To maintain patency of the fistulae, indwelling catheters were placed into the openings created by the laser. For both horses, long-term follow-up did not reveal complications, and both owners were satisfied with results of the procedure. The authors recomme...
