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.
Krogh HV, Lundegaard HC.A case of guttural pouch mycosis in an 11-year-old horse is described. The fungus isolated was identified as Emericella nidulans. Housing under bad hygienic conditions without ventilation for three years might have been a predisposing factor.
Deegen E.With the aid of a flexible glassfibre endoscope, a 300 W cold light source and a special adapted camera, colour photographs of the upper respiratory tract of horses were taken. These pictures served to present especially the disease processes of the different areas of the upper respiratory tract which lead to a constriction of the lumen. These included proliferation in the nose, guttural pouch diseases and larynx diseases such as hemiplegia, subepiglottic cysts, epiglottic entrapment and rostral displacement of the plica palatopharyngica. Furthermore endoscopic findings of changes in the soft ...
Smith KM, Barber SM.A two year old Thoroughbred gelding, presented with guttural pouch hemorrhage, had the internal and external carotid arteries ligated. Guttural pouch mycosis was detected on endoscopic examination. After one month of topical antifungal therapy, the horse was returned and euthanized because of recurrent epistaxis. A bacterial infection of the guttural pouch with associated ulceration and hemorrhage from the maxillary artery was found at necropsy.A two year old grade gelding had ulceration and hemorrhage from the external carotid artery. Utilizing balloon-tipped catheters and arterial ligation, ...
Grabner A.Using a fibreoptic endoscope ("small gastroscope" with outside diameter of 9.3 mm) a simple and sparing inspection of the guttural pouch is performed. The flap-type tube cover is opened by means of medial leverage with a guidance probe shifted through the work duct of the endoscope. The same procedure is used in diagnostic specimen collection and therapeutical measures such as irrigations. Guttural pouch topography and pathological disorders are illustrated by endoscopic photography. The different diseases such as follicular hyperplasia, ascending pharyngeal catarrh, perforating abscesses of t...
Colles CM, Cook WR.Carotid and cerebral angiography has been found to be a relatively simple technique to carry out in the horse. At most it involves a cutdown approach to the carotid artery, followed by catheterisation of the artery and selective catheterisation, if necessary, of one of its three branches. The technique can be carried out with standard equipment normally available within equine hospital facilities. The authors have employed angiography as a routine aid to diagnosis over the past nine years, without encountering any serious complications or adverse reactions. Carotid angiography has been especia...
Stick JA, Wilson T, Kunze D.Of three horses with basilar skull fractures, two died within 48 hours. The remaining horse was euthanatized because of a locomotion deficit. Clinical signs included epistaxis followed by ataxia. In each case, the basi-occipital bone and ventral portion of the calvarium were involved in the fracture. Diagnosis was based on clinical signs or radiographic appearance of guttural pouches, or both.
Freeman DE, Donawick WJ.A procedure developed to occlude the internal carotid artery of horses with guttural pouch mycosis was modified was modified and evaluated in nine clinically normal horses. The left internal carotid artery was ligated at its origin and occluded distally with an intraluminal balloon catheter. In four horses, the balloon-tipped catheters were left in place until these horses were euthanatized at 4 to 244 days after surgery. In the remaining horses, the catheters were removed after 10 to 14 days by a cutdown procedure, and these horses were euthanatized 1 to 60 days after catheter removal. In bot...
Freeman DE, Donawick WJ.An intravascular procedure was used to occlude the internal carotid artery of two horses with epistaxis caused by guttural pouch mycosis. In each horse, the affected internal carotid artery was ligated close to its origin. A balloon-tipped catheter was introduced into the artery distal to the ligature, and its tip was advanced beyond the site of infection. The balloon was then inflated so that the infected segment of artery was isolated from the cerebral vascular system. The catheters were removed at 14 and 51 days, and both horses were returned to training and racing. Neither horse had furthe...
Heffron CJ, Baker GJ, Lee R.Videofluoroscopy was used to study the deglutition reflexin 2 horses believed, on the basis of endoscopic and clinical examination, to have normal pharyngeal and laryngeal function. The reflex was found to be the same as that described in man and in the rabbit. A feature of deglutition in the horse was the temporary increase in size of the auditory tube diverticuli (gluttural pouches) as a result of contraction of the pharyngeal muscles.
Rawlinson RJ, Jones RT.The history and clinical findings of 1 horses with guttural pouch mycosis referred to us are described. The salient features of the history and clinical signs common to both cases were profuse spontaneous nasal haemorrhage, partial pharyngeal paralysis; subsequently bilateral nasal discharge containing food material, inability to drink and parotid pain became evident. One case made a gradual recovery with conservative medical treatment while the second case was destroyed and submitted for post-mortem, histopathological and microbiological examination. This examination failed to establish the i...
Firth EC.The findings in 6 experimental and 1 natural case of Horner's Syndrome (HS) are presented. The experimental cases were induced by unilateral surgical section of the cervical sympathetic trunk in the middle third of the neck. The naturally occurring case was seen in a 17 year old gelding with a mediastinal tumour. The signs of HS in these horses included ptosis, miosis, enophthalmos, hemilateral sweating and temperature increase of the face and cranial cervical region on the affected side. The intensity of these signs was variable between and within animals. Miosis, enophthalmos and temperature...
Heffron CJ, Baker GJ, Lee R.Videofluoroscopy was used to study the deglutition reflexin 2 horses believed, on the basis of endoscopic and clinical examination, to have normal pharyngeal and laryngeal function. The reflex was found to be the same as that described in man and in the rabbit. A feature of deglutition in the horse was the temporary increase in size of the auditory tube diverticuli (gluttural pouches) as a result of contraction of the pharyngeal muscles.
Smyth DA, Baptiste KE, Cruz AM, Naylor JM.A 6-year-old, 420-kg quarter horse gelding was presented with a 2-month history of difficulty swallowing and dyspnea. The horse was diagnosed with a right guttural pouch empyema with many large chondroids. Two surgeries were required to completely remove all the chondroids from what proved to be a primary distension of the guttural pouch lateral compartment.
Embertson RM.Upper respiratory tract conditions of the older horse that are not necessarily associated with athletic exercise intolerance are discussed. Some of the diseases described include ethmoid hematoma, sinus disease, guttural pouch empyema and mycosis, retropharyngeal abscess, nasopharyngeal cicatrix, arytenoid chondropathy, and neoplasia.
Grabner A.Mycosis of the guttural pouches is a sporadic disease characterized by diphtheroid-necrotizing inflammation, and is caused by different fungal species, mainly by Aspergillus spp., Penicillium spp. and Candida spp. Highest incidence is during summer in stable horses. Proper diagnosis often requires--besides detection by mycological techniques--histological examination of tissue obtained by bioptic endoscopy. Prognosis is hopeless in late stages of the infection because of the erosion of the carotid artery or accompanied by the fatal complications of a not reparable cranial nerve damage also in ...
Grabner A.Using a fibreoptic endoscope ("small gastroscope" with outside diameter of 9.3 mm) a simple and sparing inspection of the guttural pouch is performed. The flap-type tube cover is opened by means of medial leverage with a guidance probe shifted through the work duct of the endoscope. The same procedure is used in diagnostic specimen collection and therapeutical measures such as irrigations. Guttural pouch topography and pathological disorders are illustrated by endoscopic photography. The different diseases such as follicular hyperplasia, ascending pharyngeal catarrh, perforating abscesses of t...
Kendall A, Mayhew IG, Petrovski K.Treatment of subclinical carriers of Streptococcus equi subsp. equi with a gelatine-penicillin formulation deposited in the guttural pouch has been empirically proposed, but data on local tissue penicillin concentrations after treatment are lacking. Methods: We analysed tissue levels of penicillin after administration into the guttural pouches of four healthy horses. Two horses received local treatment with gelatine-penicillin and two horses received local treatment with an intramammary formulation of penicillin. Tissues were harvested for analysis either 12 or 24 h later. Conclusions: Resul...
Saulez MN, Slovis NM, Louden AT.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...
Stick JA, Wilson T, Kunze D.Of three horses with basilar skull fractures, two died within 48 hours. The remaining horse was euthanatized because of a locomotion deficit. Clinical signs included epistaxis followed by ataxia. In each case, the basi-occipital bone and ventral portion of the calvarium were involved in the fracture. Diagnosis was based on clinical signs or radiographic appearance of guttural pouches, or both.
Guida N, Mesplet M, Di Gennaro E, Digilio P, Moras EV.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.
Sullins KE.Common equine upper respiratory conditions are diagnosed via endoscopy. Endoscopic surgery facilitates correction of many conditions without general anesthesia or laryngotomy, reducing the morbidity and cost of the procedures. Modalities of endoscopic surgery include the Nd-YAG laser or electrosurgery, which may be complementary. The least expensive method is electrosurgery, and instruments are available that can be passed through the biopsy channel of the endoscope. Conditions amenable to such procedures include entrapped epiglottis, rostral displacement of the palatopharyngeal arch, pharynge...
Whitehead AE, Whitty J, Scott M, Léguillette R.A gelding was diagnosed with dysphagia and left guttural pouch mycosis. Treatments included topical antifungal drugs, systemic voriconazole, and balloon occlusion of the internal carotid artery. Ongoing dysphagia of neurological origin necessitated extra-oral feeding through an esophagostomy tube. Complementary case management included acupuncture. Clinical remission occurred over 10 weeks. Dysphagie réversible secondaire à une mycose de la poche gutturale chez un hongre traité médicalement avec du voriconazole et chirurgicalement par l’occlusion de la carotide et l’œsophagostomie. Un...
Cheramie HS, Pleasant RS, Robertson JL, Moll HD, Carrig CB, Freeman DE, Jensen ME.To evaluate an occlusion technique for the internal carotid artery of horses using an intravascular, detachable, self-sealing, latex balloon distally and ligatures proximally. Methods: Experimental study. Methods: Six healthy adult horses. Methods: In each horse, the left internal carotid artery was occluded by placement of an intravascular, detachable, self-sealing, latex balloon distally and two ligatures proximally. Radiographs were taken on days 2, 5, 10, and 30 after surgery to evaluate balloon inflation and position. Endoscopic examination of the left guttural pouch was performed 10 days...
Furniss C, Carstens A, Cilliers I.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...
Bacon Miller C, Wilson DA, Martin DD, Pace LW, Constantinescu GM.A 3-year-old Quarter Horse gelding was treated for left guttural pouch mycosis by ligation and balloon catheterization of the left internal carotid artery. Catheter advancement was shorter (10 cm) than the normally reported distance (13-15 cm), but was observed endoscopically during placement as it coursed within the internal carotid artery through the guttural pouch. The horse developed a persistently abnormal respiratory pattern after catheter placement, failed to gain consciousness, developed pulmonary edema, and died 5.5 hours postoperatively. Postmortem examination revealed an aberrant le...
Manglai D, Wada R, Kurohmaru M, Yoshihara T, Kuwano A, Oikawa M, Hayashi Y.The present study attempted to clarify the characteristics of the guttural pouch mucosa in equines and to evaluate its foreign substance clearance ability. The specimens were collected from nine regions (eight in the guttural pouch mucosa, and one in the nasopharynx mucosa). We first examined the pouch mucosa by light and electron microscopy. We then measured the frequency of goblet cells per 200 epithelial cells, the length of the cilia, the thickness of the epithelial cell layer and lamina propria and statistically analyzed the data. The guttural pouch mucosa consisted of stratified columnar...
Bryant B, Meehan LJ, Roberts V.Standing computed tomographic (CT) examination of the equine guttural pouch frequently reveals deviation of the midline septum. The significance of deviation is currently unknown. The aims of this retrospective, single-centre study were to determine the prevalence of deviation of the midline septum of the guttural pouch and determine whether there was an association between the presence and degree of deviation of the septum, and guttural pouch disease. Case records were reviewed, identifying 95 horses that had undergone a standing, sedated, head CT and guttural pouch endoscopy. The presence, l...
Manglai D, Wada R, Kurohmaru M, Sugiura T, Yoshihara T, Oikawa M, Hayashi Y.To clarify the functions of the equine guttural pouch, the distribution of various immunoglobulin isotypes and subisotypes in the guttural pouch mucosa were examined in healthy horses. IgGa was present in the mucosa of guttural pouch, mucosal lymph nodules and submucosal lymph nodules. IgM was scattered in the mucosal lymph nodules and in the germinal centers of the submucosal lymph nodules. IgGc was recognized only in the submucosal lymph nodules. These immunoglobulin isotypes and subisotypes were found in lymphocytes and plasma cells. On the other hand, IgA was detected in glandular epitheli...
Baptiste K.The pharyngeal orifice of the equine auditory tube has not been adequately described. Its larger size and position, further rostral within the nasopharynx compared with other species, cannot be easily explained, but could be important for the proposed brain-cooling function of the guttural pouches; however, unlike other species, it may not be the sole regulator of auditory tube aeration. A 'second orifice' (representing the final entrance to the auditory tube diverticulum) deserves recognition in performing a role in air exchange between the auditory tube, diverticulum and middle ear. The resu...
Cheramie HS, Pleasant RS, Dabareiner RM, Carolan RO.An aberrant branch of the internal carotid artery was detected by angiography in a horse with guttural pouch (auditory tube diverticulum) mycosis after the distal portion of the artery had been occluded by use of a detachable latex balloon. A second balloon was placed to eliminate retrograde hemorrhage from the aberrant branch. The horse recovered and returned to its previous activity. Vascular anomalies of the internal carotid artery my be more common than expected, and have resulted in fatal complications during and after surgical treatment in guttural pouch mycosis. Intraoperative identific...
Schumacher J, Hanselka DV.Nasopharyngeal cicatrices were observed endoscopically in 47 horses examined because of abnormal respiratory noises and/or exercise intolerance. A review of these cases revealed a correlation between cicatrization and age, sex, and the presence of other upper airway abnormalities. The age of affected horses ranged from 6 to 21 years, with a mean age of 12.7 +/- 7.8 (+/- 2 SD) years. Females were affected 2.7 times more frequently than males. Abnormalities commonly observed with a nasopharyngeal cicatrix included chondritis of the arytenoid cartilage, epiglottic deformity, and deformity of the ...
van der Vossen N, Cavalcante P, Glynn S, Achappa D, Mehmood W, Oikawa M, Vinardell T, Jamieson C.Upper respiratory disease was reported over many seasons in Arabian foals on a single stud farm in the Middle East. Affected foals were noted to have mucopurulent nasal discharge, cough, fever and tachypnea. All affected foals had been empirically treated with a macrolide and rifampicin, by the referring veterinarian without improvement. On endoscopic examination, all affected foals had significant guttural pouch empyema (GPE). (1) To document a previously unreported presentation of guttural pouch empyema (GPE) in a family of juvenile Arabian foals; (2) To document the cytological and microbia...
