The pharynx in horses is a muscular tube that serves as a passageway for both the respiratory and digestive systems. It connects the nasal and oral cavities to the larynx and esophagus, facilitating the movement of air to the lungs and food to the stomach. The equine pharynx plays a role in breathing, swallowing, and vocalization. Anatomically, it is divided into the nasopharynx, oropharynx, and laryngopharynx, each with distinct functions. This section provides access to peer-reviewed research studies and scholarly articles that explore the anatomy, physiology, and clinical relevance of the pharynx in equine health, including its involvement in respiratory and swallowing disorders.
Hance SR, Bertone AL.Equine tumors are rather uncommon; however, of the body regions, the head is a relatively common location for neoplasia, including sarcoids and squamous cell carcinomas of the skin, tumors of the sinus/nasal cavity, and bony tumors of the head. Tumors discussed in the article include odontogenic and bony tumors; sarcoids; tumors of the guttural pouch and pharyngeal and oral mucosa; tumors of the larynx; and tumors of the paranasal sinuses and nasal passages. In general, tumors involving deeper structures of the head carry a poor prognosis; however, some tumors such as sarcoids, ossifying fibro...
Hardy J, Stewart RH, Beard WL, Yvorchuk-St-Jean K.Pharyngeal or esophageal trauma was diagnosed in 9 horses after nasogastric intubation. Evidence of trauma (edema or ulceration) was detected in the pharynx of 3 horses and in the esophagus of 6 horses. Complications associated with nasogastric intubation were first observed in 5 horses while they were intubated and in 4 horses after extubation. Clinical signs of pharyngeal or esophageal trauma were similar, and included salivation, bruxism, coughing, and nasal discharge. Treatment, including extubation, enteral feeding through a small nasogastric tube, or esophagostomy distal to the affected ...
Traub-Dargatz JL, Ingram JT, Stashak TS, Kiper ML, Tarr S, Child G, MacAllister CG.Four Quarter Horse foals ranging in age from 6 days to 2 months were determined to have upper airway stridor secondary to polymyopathy suspected to be hyperkalemic periodic paralysis. Electromyography revealed spontaneous muscle activity in all muscles examined. Electromyographic findings were similar in the dams of 3 foals (No. 1, 3 and 4). Hyperkalemia was found in foals 1 and 4. Endoscopically, the upper airway stridor in foals 1 and 3 was confirmed to be attributable to laryngeal and pharyngeal collapse or spasm. Foals 1, 2, and 3 were treated with acetazolamide. Foal 4 was not treated, at...
Hance SR, Robertson JT, Bukowiecki CF.Two horses were examined for compression of the pharynx from the dorsal pharyngeal wall. Neither horse had a patent opening of 1 of the guttural pouches. Radiography of the guttural pouch region revealed a retropharyngeal opacity that occluded 1 guttural pouch. Organisms were not isolated on bacteriologic culture of fluid obtained from the affected guttural pouch. Surgical exploration of the guttural pouch revealed the lining to be easily removeable by blunt dissection in 1 horse; however, the lining was more firmly attached and removal was not attempted in the second horse. A fenestration bet...
Kiper ML, Wrigley R, Traub-Dargatz J, Bennett D.Seven horses with metallic foreign bodies in the mouth or pharynx were examined at the Colorado State University Veterinary Teaching Hospital from 1983 to 1989. The horses had variable clinical signs, such as purulent nasal discharge, swelling of the throatlatch area, and dyspnea. Most of the horses had clinical signs for more than 2 weeks, and had no or only temporary improvement with conservative medical treatment (antibiotics, nonsteroidal anti-inflammatory drugs). The definitive diagnostic test in all of the cases was radiography, which also aided in the plan for surgical removal of the fo...
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...
Proudman CJ, Knottenbelt DC, May SA, Edwards GB.Several imaging techniques were used to diagnose hypoplasia of the soft palate in a horse. The absence of the caudal soft palate, hypertrophied lymphoid tissue and the formation of a pseudouvula were observed endoscopically. Plain and contrast radiography were used to demonstrate a soft palate remnant and to identify structures rostral to the epiglottis. Retrograde endoscopy of the pharynx via a tracheotomy incision is described.
Gaughan EM, Gift LJ, DeBowes RM, Frank RK, Veatch JK.An 8-year-old Quarter Horse mare was examined for chronic nasal discharge and obstruction of both nasal passages. A solid mass lesion was identified in the maxillary sinuses, soft palate, nasal and pharyngeal cavities. Palliative surgery was used to debulk the lesion and facilitate nasal airflow. Squamous cell carcinoma was diagnosed from surgical biopsies. Approximately 7-8 weeks after surgery, the mare was observed to be acutely blind. Ophthalmologic examination revealed central origin blindness and active retinitis. The squamous cell carcinoma had reobstructed the nasal passages. Pressure b...
Pearson EG.Of 41 equids referred to a veterinary teaching hospital in the Pacific northwest because of dyspnea and inspiratory noise, 3 ponies were diagnosed as having liver failure, most likely attributable to pyrrolizidine alkaloid toxicosis. Dyspnea appeared to be caused by laryngeal and/or pharyngeal paralysis. It is proposed that this paralysis was a manifestation of hepatic encephalopathy. Although these clinical signs are not common for pyrrolizidine toxicosis, practitioners should be aware of the possibility so that misdiagnosis of other causes of inspiratory dyspnea may not be made.
Powell DG.The diagnosis of any viral respiratory disease relies on laboratory procedures to isolate the virus and demonstrate a significant rise in serum antibody titers. To isolate viruses from the upper respiratory tract, it is imperative that nasopharyngeal swabs are obtained from animals in the early acute stage of illness, i.e., during the pyrexic phase when the virus is replicating. Nasopharyngeal swabs must be placed in a virus transport medium and forwarded immediately to the laboratory at refrigerated temperature. Equine influenza, rhinopneumonitis, and equine viral arteritis are the three vira...
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.
Hardy J.Upper airway obstruction may result from nasal, pharyngeal, or tracheal diseases. In the young horse, a relatively severe obstruction usually is present before clinical signs are evident. This article reviews the clinical manifestations, diagnostic features, treatment, and outcome of commonly encountered conditions of the nasal passages, pharynx, larynx, and trachea in young horses.
Dean PW.Abnormalities of the nasal cavity, pharynx, larynx, and trachea result in respiratory noise and exercise intolerance. Clinical features of common upper respiratory conditions of performance horses are reviewed with emphasis on diagnosis, treatment, and risk factors that affect the outcome of surgical treatment.
Sweeney CR, Maxson AD, Soma LR.The frequency of upper respiratory tract abnormalities was determined in a selected population of racing Thoroughbreds. The prevalence of pharyngeal lymphoid hyperplasia was 34.2%; left laryngeal hemiplegia was 1.8%; and epiglottic entrapment was 0.74%. Excluding pharyngeal lymphoid hyperplasia and tracheal exudate, 3.7% of the population examined had upper respiratory tract abnormalities.
Bailey GD, Love DN.Two hundred and seventy bacterial isolates were obtained from the pharyngeal tonsillar surface of 12 normal horses and 98 obligatory anaerobic bacteria were characterised. Of these, 57 isolates belonging to 7 genera (Peptostreptococcus (1); Eubacterium (9); Clostridium (6); Veillonella (6); Megasphera (1); Bacteroides (28); Fusobacterium (6)) were identified, and 16 of these were identified to species level (P. anaerobius (1); E. fossor (9); C. villosum (1); B. fragilis (1); B. tectum (2); B. heparinolyticus (2)). Three hundred and twenty isolates were obtained from 23 samples from horses with...
Pirie M, Pirie HM, Wright NG.The surface features of the upper respiratory tract of 20 clinically normal horses of various ages and types were studied with scanning electron microscopy. In the rostral part of the nasal cavity, there was a wide zone of non-ciliated epithelium whereas, caudally, the surface was well ciliated. This latter type of epithelium extended into the nasopharynx and guttural pouches although scattered areas of non-ciliated microvillous cells were also found.
Tulleners E, Mann P, Raker CW.Epiglottic augmentation with injectable bovine collagen or an autogenous or allogenous auricular cartilage graft was performed in 12 horses with endoscopically and radiographically normal epiglottises. The grafting procedures were easy to perform and did not cause apparent discomfort. Cartilage graft extrusion or resorption may have occurred, but was not seen by endoscopy and lateral laryngeal radiography. Only collagen implants remained evident endoscopically, as smooth round submucosal bulges ventral to the epiglottic cartilage. Two horses with collagen implants, and all horses with cartilag...
Morris EA, Seeherman HJ.Forty-six racehorses with a history of poor performance underwent endoscopic evaluation of laryngeal and pharyngeal function while exercising on a high-speed treadmill. This evaluation allowed the definitive diagnosis of intermittent or continual upper respiratory tract obstruction as a cause of poor performance, as well as the documentation of the dynamic functional anatomy of the obstruction. Ten of the horses (22%) were determined to have a functional abnormality of the upper respiratory tract. These abnormalities included epiglottic entrapment (1 horse), persistent dorsal displacement of t...
French DA, Pharr JW, Fretz PB.Diagnostic ultrasonography was used during surgery to assist in the removal of a piece of wire from the retropharyngeal region. A 3-year-old Quarter Horse mare was referred with dysphagia of 2 days' duration. Radiography revealed a 9-cm piece of wire located caudodorsal to the larynx. A ventral surgical approach was performed, dissecting along the right side of the larynx and trachea. The surgical field was filled with 0.85% sterile physiologic saline solution. A 5 MHz-mm sector scanner probe immersed in the fluid was able to locate the wire and facilitate the direction and depth of dissection...
Adams R, Calderwood-Mays MB, Peyton LC.Three horses were examined for ulcerative pharyngitis, which had been unresponsive to treatment. Biopsy specimens of the pharyngeal lesions were characterized histologically by a mixed population of lymphocytes and histiocytes, suggesting chronic inflammation. Only when biopsy specimens of regional lymph nodes revealed this cell population disrupting the lymph node architecture was the diagnosis of malignant lymphoma made.
Mair TS, Batten EH, Stokes CR, Bourne FJ.Mucosal lymphoid nodules were identified within the equine respiratory tract by an acetic acid fixation technique. Nodules were identified in foetuses from nine months gestational age, and estimates of total and regional nodule populations were made in foetal, neonatal and adult horses. Nodules occurred at specific sites within the tract, which probably relate to areas where inhaled antigens accumulate. The largest populations of nodules occurred in the nasopharynx and larynx, with smaller numbers in the nasal cavity, trachea and bronchi. There was an age-related change in the size of these no...
Greet TR.This paper describes the outcome of treatment of 30 cases of guttural pouch mycosis by ligation of the internal carotid artery on the cardiac side of the lesion and lavage of the affected pouch with natamycin. Twenty-three horses recovered fully following this treatment while laryngeal hemiplegia persisted in one case and slight dysphagia caused by pharyngeal hemiplegia in another. The remaining five horses died or were destroyed. Five horses with guttural pouch mycosis, which had shown no epistaxis but had pharyngeal hemiplegia, were treated by topical natamycin alone. Only two of these survi...
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 ...
Church S, Wyn-Jones G, Parks AH, Ritchie HE.Seventeen cases of guttural pouch mycosis (including two bilaterally affected cases) were diagnosed in a three year period. The presenting signs were, in order of frequency, epistaxis at rest, nasal catarrh, pharyngeal paralysis, ipsilateral laryngeal hemiplegia, swelling of the submandibular/parotid region, extension of the head and neck and dyspnoea. Ligation of the origin of the internal carotid and occipital arteries was attempted in 10 of the cases exhibiting epistaxis. Bilateral ligation was performed on one animal with an untoward sequelae. Where surgery was successfully completed furth...
Hance SR, Robertson JT, Bukowiecki CF.Two horses were examined for compression of the pharynx from the dorsal pharyngeal wall. Neither horse had a patent opening of 1 of the guttural pouches. Radiography of the guttural pouch region revealed a retropharyngeal opacity that occluded 1 guttural pouch. Organisms were not isolated on bacteriologic culture of fluid obtained from the affected guttural pouch. Surgical exploration of the guttural pouch revealed the lining to be easily removeable by blunt dissection in 1 horse; however, the lining was more firmly attached and removal was not attempted in the second horse. A fenestration bet...
Tessier C, Holcombe SJ, Stick JA, Derksen FJ, Boruta D.There is a need to understand the process which leads to failure of recruitment of the stylopharyngeus muscle in clinical cases of nasopharygeal collapse. We therefore studied the timing and intensity of stylopharyngeus muscle activity during exercise in horses. Objective: To measure the electromyographic (EMG) activity of the stylopharyngeus muscle in exercising horses and correlate it with the breathing pattern. Methods: Five horses were equipped with a bipolar fine wire electrode placed on the stylopharyngeus muscle and a pharyngeal catheter. The horses exercised on a treadmill at speeds co...
Norman TE, Chaffin MK, Bisset WT, Thompson JA.To characterize the associations between clinical signs of nasopharyngeal cicatrix syndrome (NCS) and endoscopic findings in horses. Methods: Retrospective, case-control study. Methods: 239 horses (118 case horses and 121 control horses). Methods: Medical records of horses that had an endoscopic evaluation of the upper airway performed between January 2003 and December 2008 were reviewed. Clinical signs and the appearance and anatomic locations of lesions identified during endoscopic evaluation were reviewed and recorded for each horse. The associations between clinical signs and endoscopic fi...
Koch DW, Easley JT, Nelson BB, Delcambre JJ, McCready EG, Hackett ES.Auditory tube diverticula, also known as guttural pouches, are naturally occurring dilations of the auditory tube in horses that communicate with the nasopharynx through a small ostium. Infection and select other conditions can result in inflammation and narrowing of the nasopharyngeal ostium, which prevents drainage of fluid or egress of air and can lead to persistent infection or guttural pouch tympany. Auditory tube diverticulotomy allows continuous egress from the auditory tube diverticula and is a feature of disease treatment in horses, in which medical treatment alone is not successful. ...
Beard WL, Holcombe SJ, Hinchcliff KW.To determine the effect of a tongue-tie on upper airway mechanics in clinically normal horses exercising on a treadmill following sternothyrohyoid myectomy. Methods: 6 Standardbreds. Methods: Upper airway mechanics were measured with horses exercising on a treadmill at 5, 8, and 10 m/s 4 weeks after a sternothyrohyoid myectomy was performed. Pharyngeal and tracheal inspiratory and expiratory pressures were measured by use of transnasal pharyngeal and tracheal catheters connected to differential pressure transducers. Horses were fitted with a facemask and airflow was measured by use of a pneumo...
Barton AK, Cehak A, Rohn K, Ohnesorge B.To determine outcome after transendoscopic laser fenestration of the median septum and removal of the salpingopharyngeal fold of the guttural pouch on nasopharyngeal obstruction caused by poll flexion in Warmblood horses. Methods: Clinical study. Methods: Horses (n = 9). Methods: Nine horses with a history of performance insufficiency and respiratory noise during poll flexion were examined. On endoscopy, an often asymmetric dorsoventral obstruction of the nasopharynx occurred during poll flexion. Left lateral radiographs were taken in neutral, extended, and flexed head positions showed that me...
Bayly WM, Slocombe RF.Effects of respiratory tract obstructions on ventilatory mechanics in horses exercising at high speeds were tested with a fibreglass replica of the airways (nares to mainstem bronchi) of an adult horse. Segmental pressures were recorded at six sites along the model at four different unidirectional flows (1300-4100 litre min-1), and the respective resistances (R) to airflow were calculated. The external nares and the larynx made the greatest contributions to the total resistance (RTOT) when no obstruction was present. Modifying the model to simulate severe pharyngeal lymphoid hyperplasia (PLH) ...
Gomez-Villamandos RJ, Santisteban Valenzuela JM, Ruiz Calatrava I, Gomez-Villamandos JC, Avila Jurado I.A study was made of the effects of low-level laser irradiation on the cicatrization of superficial wounds in the pharyngeal mucosa of the horse. Methods: Duplicate pharyngeal mucosal ulcers were induced in 12 Spanish horses with submucosal injection of sulfuric acid. A fibroendoscope and an He-Ne laser were used to treat one of the ulcers and the second ulcer in each animal was left untreated, serving as a control. Biopsy samples for the histological study were taken after the seventh laser therapy session from the two animals. Results: Irradiated lesions cicatrized at 10.5 days and nonirradia...
McGreevy PD, Richardson JD, Nicol CJ, Lane JG.There is confusion in the veterinary literature concerning the definition of oral based stereotypies in the horse. This study reports the use of fluoroscopy and endoscopy during cribbiting/wind-sucking in afflicted horses. This permitted observations of movements of the pharyngeal and oesophageal tissues and of the air column within during the stereotypic behaviour. The findings reported show that the sequence of events during crib-biting/wind-sucking is not related to deglutition and that air is not swallowed to the stomach. Transient dilation of the upper oesophagus was recorded and the char...
Toft K, Kjeldsen ST, Otten ND, van Galen G, Fjeldborg J, Sinding M, Hansen S.Flexion of the horse's head and neck during dressage riding reduces the pharyngeal lumen with the risk of increased upper airway resistance and upper airway obstructions. According to the Fédération Equestre Internationale, hyperflexion is achieved through force, whereas the position low-deep-round is nonforced. The objectives of this study were to evaluate (1) applied rein tension and (2) dynamic structural disorders in the upper airways in dressage horses in different gaits and different head-neck positions (HNPs). Overground endoscopy (OGE) and rein tension were evaluated in 13 clinically...
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...
Woodie JB, Ducharme NG, Hackett RP, Erb HN, Mitchell LM, Soderholm LV.Dorsal displacement of the soft palate (DDSP) is a common condition in racehorses for which various surgical treatments are often performed. In light of recent findings that suggested the position of the larynx may influence the occurrence of DDSP, we investigated whether a noninvasive mean of affecting the position of the larynx could be effective in the management of DDSP. Objective: An external device (laryngohyoid support; LHS) positioning the larynx in a more rostral and dorsal location and preventing caudal displacement of the basihyoid bone would be effective in preventing DDSP during s...
Lindsay FE, Clayton HM.Using histological techniques, anatomical dissection, fibre optic endoscopy and radiography, the nasopharynx and larynx of the donkey were examined and described. Compared with horses, donkeys have a much deeper pharyngeal recess extending 4.0-6.0 cm caudally from a constricted orifice, through which it communicates with the nasopharynx. Movements of the membranous lining of the recess reflect pressure changes in the upper airways. A shallow, thumb shaped depression on the rostral face of each vocal fold corresponds in position to the lateral ventricle in the horse. In the donkey, large paired...
McClure SR, Schumacher J, Snyder JR.Three horses were found to have an extensive nasopharyngeal cicatrix that was responsible for respiratory impairment. The cicatrization was diagnosed by use of endoscopy during evaluations of the horses for inspiratory stridor. All 3 horses were treated by endoscope-guided transnasal incision of the cicatrix and were able to resume their previous activities.
Sinclair EA.A pharyngeal cyst was diagnosed in a 5-year-old Dutch Warmblood mare, after presentation for coughing, dyspnea, and abnormal respiratory noise. Complete surgical excision was performed and the mare returned to normal function and performance. Histopathology found no evidence of thyroglossal duct remnants. Kyste pharyngien chez un Warmblood hollandais âgé de 5 ans. Un kyste pharyngien a été diagnostiqué chez une jument Warmblood hollandaise âgée de 5 ans qui avait été présentée pour un problème de toux, dyspnée et bruit respiratoire anormal. Une excision chirurgicale complète a é...
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 ...
Bertone JJ, Traub-Dargatz JL, Trotter GW.Endoscopic examination of a 7-year-old gelding with weight loss indicated a palatal defect with a prominent tissue mass at the caudomedial margin of the defect. At necropsy, the condition was determined to be bilateral hypoplasia of the soft palate.
Sweeney CR, Sweeney RW, Raker CW, Freeman DE.A 3-year-old Thoroughbred filly had a pharyngeal abscess causing obstruction of the upper respiratory tract. Diagnosis was made by a combination of endoscopy, biopsy, cytology, and radiography. Treatment with antimicrobials and analgesics resulted in successful resolution of the abscess.