Salpingopharyngeal fistula as a treatment for guttural pouch mycosis in seven horses.
Abstract: Guttural pouch mycosis (GPM) is a cause of nasal discharge, dysphagia and fatal haemorrhage in the horse. Objective: To report the complications and success of salpingopharyngeal fistulation in horses with GPM. We hypothesised that creating a direct static opening into the guttural pouch from the pharynx would cause a regression of fungal plaques due to a change in the guttural pouch environment and that this treatment would result in resolution of infection prior to secondary complications. Methods: Retrospective case series. Methods: The medical records of all horses diagnosed with GPM that were presented to New Bolton Center between the years 2006 and 2017 were examined retrospectively. Seven cases of guttural pouch mycosis treated with salpingopharyngostomy without other surgical intervention were included. Information collected included signalment, presenting complaint, which pouch was affected, size and location of the plaques, laryngeal and pharyngeal function, concurrent medical therapy, location of the fistula, surgical time, time to resolution of clinical signs, time to full resolution of the mycotic plaque, and patency of the salpingopharyngostomy site. Results: Nasal discharge resolved in 10-30 days post-operatively in all cases where nasal discharge was present. The mycotic plaques showed complete resolution at time points ranging from 1 to 6 months post-operatively. No case developed epistaxis or neurological deficits post-operatively that were not present at presentation. Conclusions: There were differing adjunctive treatments between cases. This technique is not appropriate for horses that have had epistaxis or are currently bleeding. Conclusions: Salpingopharyngostomy can minimise cost of treatment, be performed on an outpatient basis and provide better exposure of the infected area with few complications. This case series documents seven cases treated with this method that resolved the infection without any further complications of the mycosis.
© 2018 EVJ Ltd.
Publication Date: 2018-04-24 PubMed ID: 29514400DOI: 10.1111/evj.12830Google Scholar: Lookup
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- Journal Article
Summary
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The research explores a new treatment method for guttural pouch mycosis in horses, a condition that can potentially cause nasal discharge, dysphagia, and fatal hemorrhage. The study tested the use of a procedure called salpingopharyngostomy on seven horses and found it effective in resolving the condition with minimum complications.
Research Details
The study was a retrospective case series conducted at the New Bolton Center. Medical records of horses diagnosed with guttural pouch mycosis between 2006 and 2017 were thoroughly examined for this study. The researchers focused their investigation on seven horses that were treated with the salpingopharyngostomy procedure alone.
- Key data collected in the study were information about the horses (signalment), the initial complaint, the pouch affected, the size and location of the fungal plaques, the function of the larynx and pharynx, concurrent medical therapy, the location of the fistula, and surgical time.
- Other data collected were time taken to resolve clinical signs, time taken for complete resolution of the mycotic plaque, and patency of the salpingopharyngostomy site.
Results
Post-surgery, all horses with a nasal discharge showed recovery within 10-30 days while complete resolution of mycotic plaques varied but was achieved between 1 to 6 months post-operation. Interestingly, no cases developed epistaxis or neurological deficits post-operation if they were not present at the time of presentation.
Conclusions
The study notes that there were variations in adjunctive treatments across cases. The authors advise against using the technique for horses that have had epistaxis or are currently bleeding. Despite these limitations, salpingopharyngostomy emerges as a cost-effective treatment that can be performed on an outpatient basis and provides better exposure to the infected area with minimal complications. All seven horses in the case series treated with this method showed resolution of the infection without experiencing any further complications from the mycosis.
Cite This Article
APA
Watkins AR, Parente EJ.
(2018).
Salpingopharyngeal fistula as a treatment for guttural pouch mycosis in seven horses.
Equine Vet J, 50(6), 781-786.
https://doi.org/10.1111/evj.12830 Publication
Researcher Affiliations
- University of Pennsylvania New Bolton Center, Kennett Square, Pennsylvania, USA.
- University of Pennsylvania New Bolton Center, Kennett Square, Pennsylvania, USA.
MeSH Terms
- Animals
- Carotid Artery Diseases / prevention & control
- Carotid Artery Diseases / veterinary
- Chemotherapy, Adjuvant / veterinary
- Endoscopy / methods
- Endoscopy / veterinary
- Female
- Fistula
- Hemorrhage / prevention & control
- Hemorrhage / veterinary
- Horse Diseases / drug therapy
- Horse Diseases / microbiology
- Horse Diseases / prevention & control
- Horse Diseases / surgery
- Horses
- Laser Therapy / veterinary
- Male
- Mycoses / drug therapy
- Mycoses / surgery
- Mycoses / veterinary
- Pharynx / surgery
- Retrospective Studies
Citations
This article has been cited 9 times.- Lepage H, de Chaisemartin C, Spadaro Rosselo A, Leroy H, Lepage O. Endoscopically assisted transcutaneous placement of a balloon catheter in the medial guttural pouch compartment of the horse: A surgical approach to local treatment. Vet Surg 2026 Jan;55(1):131-141.
- Jeong S, Bond S, Bayly W, Sole-Guitart A. Laser fenestration of the dorsal pharyngeal recess does not correct experimentally induced dorsal nasopharyngeal collapse in horses. Vet Surg 2026 Jan;55(1):88-100.
- Hardefeldt L, Thomas K, Page S, Norris J, Browning G, El Hage C, Stewart A, Gilkerson J, Muscatello G, Verwilghen D, van Galen G, Bauquier J, Cuming R, Reynolds B, Whittaker C, Wilkes E, Clulow J, Burden C, Begg L. Antimicrobial prescribing guidelines for horses in Australia. Aust Vet J 2025 Dec;103(12):781-889.
- Waitt Wolker LH, Black A, Lee JK. Dermatitis, cellulitis, and osteomyelitis caused by Aspergillus nidulans in a horse with pituitary pars intermedia dysfunction. J Vet Diagn Invest 2024 Mar;36(2):248-253.
- Lepage OM. Guttural Pouch Mycosis: A Three-Step Therapeutic Approach. Vet Sci 2024 Jan 19;11(1).
- Piat P, Cadoré JL. Endoscopic Anatomy of the Equine Guttural Pouch: An Anatomic Observational Study. Vet Sci 2023 Aug 26;10(9).
- Dobiáš R, Jahn P, Tóthová K, Dobešová O, Višňovská D, Patil R, Škríba A, Jaworská P, Škorič M, Podojil L, Kantorová M, Mrázek J, Krejčí E, Stevens DA, Havlíček V. Diagnosis of Aspergillosis in Horses. J Fungi (Basel) 2023 Jan 25;9(2).
- Lepage OM, Di Francesco P, Moulin N, Gangl M, Texier G, Marchi J, Cadoré JL. The Effect of Topical Oxygen Therapy in Horses Affected with Mycosis of the Guttural Pouch: An Experimental Pilot Study and a Case Series. Animals (Basel) 2021 Nov 22;11(11).
- Koch DW, Easley JT, Nelson BB, Delcambre JJ, McCready EG, Hackett ES. Comparison of two techniques for transpharyngeal endoscopic auditory tube diverticulotomy in the horse. J Vet Sci 2018 Nov 30;19(6):835-839.
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