Salpingoscopy for the treatment of recurrent guttural pouch tympany in a filly

Endoscopic Anatomy of the Equine Guttural Pouch: An Anatomic Observational Study

Guttural pouch endoscopy allows for both the visualization and treatment of many clinical problems in the equine retropharyngeal region. This area is extremely complex, and its description remains a real challenge for veterinary anatomists and practitioners. Six clinically normal equine cadavers were employed. Conventional dissections of guttural pouches without penetrating the guttural pouch membrane were first performed, and each adjacent structure was identified. Then, a guttural pouch endoscopic exam of the dissected heads was performed in order to correctly map each visible underlying anatomic structure identified in the previous dissection. This allowed us to: 1-identify each structure visible on endoscopic examination of the guttural pouch; 2-create a representative map of all the structures accurately identified via endoscopy; and 3-describe a systematic guttural pouch endoscopic examination with practical keys to help identification of the underlying vital structures. Our investigation provides new practical information on guttural pouch endoscopic anatomy and has allowed us to identify structures that were not previously described. We believe that this information may help with an accurate diagnosis in some cases and also potentially reduce iatrogenic trauma to important structures.

Surgical Treatment of a Retropharyngeal Abscess in a Japanese Black Cow

Simple Summary

Causes of inappetence and dysphagia in cow include swallowing foreign bodies, such as a magnet or a sharp object, or trauma to the posterior pharyngeal area during oral administration. The cow in this case had formed a large abscess in her pharynx that obstructed the entrance to her trachea, although the cause was unknown. By using ultrasound equipment to check the thin walls of the abscess and the distribution of blood vessels, a hole was drilled in the appropriate area, which allowed the internal pus to drain and heal. Ultrasound diagnostic equipment is useful in diagnosing abscesses deep inside the body.

Abstract

A 17-month-old Japanese Black cow presented with inappetence, wheezing, dysphagia, and drooling. Radiography and ultrasonography revealed an oval, dorsal, pharyngeal mass, with an internal horizontal line demarcating the radiolucent area from the radio-opaque area. Upper airway endoscopy revealed pus-like deposits in the dorsal nasal passage, hyperemia, and edema in the dorsal pharynx, leading to swelling and airway obstruction. Manual palpation, after sedation, revealed a thickened mass surface, which was difficult to rupture with manual pressure. After inserting a linear sonographic probe through the mouth to establish the vascularity surrounding the mass and to identify a relatively thin-walled area, a trocar was pierced into the mass under endoscopic guidance, and the opening was enlarged manually. The mass was filled with stale pus-like material, which was removed manually. The abscess cavity was washed using saline and povidone–iodine. Day 1 post-surgery, dysphagia and wheezing disappeared. Day 16 post-surgery, endoscopy showed significant improvement in the airway patency. One year postoperatively, the owner reported that the cow had an uneventful recovery. For deep abscesses, such as bovine pharyngeal abscesses, it is important to perform a preoperative transoral Doppler ultrasonography to assess the vascularity and thickness of the abscess wall for safe trocar insertion and abscess drainage.

Comparison of two techniques for transpharyngeal endoscopic auditory tube diverticulotomy in the horse

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. Transpharyngeal endoscopic auditory tube diverticulotomy was performed using a diode laser either at a single dorsal pharyngeal recess location or bilaterally caudal to the nasopharyngeal ostium in 10 horse head specimens. Both methods resulted in clear communication between the nasopharynx and auditory tube diverticula. Diverticulotomy performed in the dorsal pharyngeal recess required less laser energy and activation time and had a shorter surgical duration than diverticulotomy performed caudal to the nasopharyngeal ostium. Further study related to the clinical application of both techniques is warranted.