Fistulation of the auditory tube diverticulum (guttural pouch) with a neodymium:yttrium-aluminum-garnet laser for treatment of chronic empyema in two horses.

The research article discusses the successful treatment of two horses suffering from chronic empyema in the guttural pouch, which didn’t improve with medical treatment. The condition was resolved by creating a fistula in the cartilage of the pharyngeal orifice using a neodymium:yttrium-aluminum-garnet laser. Indwelling catheters were used to keep the created fistulae open, and long-term follow-ups showed no complications, with owners satisfied with the outcomes of the procedures.

Explanation of the Research Paper

• The paper focuses on an innovative approach used to treat chronic empyema of the auditory tube diverticulum, also known as the guttural pouch, in two horses. This study is significant since the condition is typically challenging to manage using traditional medical treatments.
• Chronic empyema in horses involves the accumulation of pus in the guttural pouch due to an infection. In this report, one horse had bilateral (in both pouches) chronic empyema, while the other had unilateral (affecting only one side).
• When the ordinary medical treatments didn’t show significant improvement, the researchers applied a new technique. They used a neodymium:yttrium-aluminum-garnet laser to create a fistula (an artificial passage) in the cartilage of the pharyngeal orifice. The laser was used in a non-contact manner, which likely minimized trauma to the surrounding tissues.
• After the creation of the fistulae, indwelling catheters were inserted into the openings. These catheters facilitated the drainage of the accumulated pus and helped maintain the openness (patency) of the fistulae. The treatment aimed to enable natural clearing and prevention of further accumulation of the pus.
• Long-term follow-up of the two treated horses did not reveal any complications resulting from the procedure. Furthermore, both horse owners reported satisfaction with the outcome of the intervention. This positive result suggests the viability of this technique for non-responsive or severe cases of chronic guttural pouch empyema in horses.
• The authors thus recommend this new treatment procedure as a potential solution for horses not responding to standard medical treatments for chronic empyema of the guttural pouch.