Diseases of the guttural pouches

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Diseases of the guttural pouches Joanne Hardy, DVM, PhD, Renée Léveillé, DVM Veterinary Clinics: Equine Practice Volume 19, Issue 1, Pages 123-158 (April 2003) DOI: 10.1016/S0749-0739(02)00070-6

Fig. 1 Endoscopy of the medial compartment of the right guttural pouch showing the internal carotid artery (arrow) and cranial nerves IX, X, XI, and XII (arrowhead). Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 2 Endoscopy of the ventral aspect of the medial compartment showing the external carotid artery coursing along the lateral wall (arrow). Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 3 Endoscopy of the lateral compartment illustrating the course of the maxillary artery (arrow) and the caudal auricular artery (arrowhead). Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 4 View of the bony skull of a horse showing the acoustic meatus and stylomastoid foramen, where the facial and vestibulocochlear nerves exit the skull. Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 5 Endoscopy of the pharynx showing insertion of the biopsy forceps into the pharyngeal opening of the left guttural pouch. Note the eccentric location of the biopsy forceps as they exit the end of the endoscope. Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 6 Endoscopy of the pharynx showing insertion of a Chambers catheter to spread the medial lamina of the pharyngeal opening to the guttural pouch so as to facilitate entry of the endoscope. Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 7 Unilateral purulent nasal discharge in a horse with guttural pouch empyema. Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 8 (A) Endoscopy of the guttural pouch showing a fluid line consistent with guttural pouch empyema. (B) Lateral projection of the head of a horse with guttural pouch empyema. The arrows point to a fluid line within the guttural pouch. Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 8 (A) Endoscopy of the guttural pouch showing a fluid line consistent with guttural pouch empyema. (B) Lateral projection of the head of a horse with guttural pouch empyema. The arrows point to a fluid line within the guttural pouch. Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 9 (A) Endoscopy of the guttural pouch showing chondroids (arrow) on the floor of the medial compartment. (Courtesy of Warren Beard, DVM, The Ohio State University, Columbus, OH.) (B) Lateral projection of the guttural pouch of a horse with chondroids (arrow). Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 9 (A) Endoscopy of the guttural pouch showing chondroids (arrow) on the floor of the medial compartment. (Courtesy of Warren Beard, DVM, The Ohio State University, Columbus, OH.) (B) Lateral projection of the guttural pouch of a horse with chondroids (arrow). Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 10 (A) Endoscopy of the guttural pouch showing a raised mass on the ventral floor of the medial compartment in a horse with a retropharyngeal abscess (arrow). (B) Lateral projection of the skull in a horse with a retropharyngeal abscess (arrow). Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 10 (A) Endoscopy of the guttural pouch showing a raised mass on the ventral floor of the medial compartment in a horse with a retropharyngeal abscess (arrow). (B) Lateral projection of the skull in a horse with a retropharyngeal abscess (arrow). Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 11 Endoscopy of a foal with guttural pouch tympany showing severe collapse of the dorsal pharyngeal wall. Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 12 Illustration of a foal with guttural pouch tympany. Note the severe distention in the region of Viborg's triangle. Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 13 Lateral projection of the head of a foal with guttural pouch tympany showing distention of the guttural pouch with air (arrow). Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 14 Endoscopy of the guttural pouch during fenestration of the median septum for treatment of tympany. (Courtesy of Warren Beard, DVM, The Ohio State University, Columbus, OH.) The arrow points to the median septum, which is being fenestrated. Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 15 Angiography of the internal carotid artery in a horse with guttural pouch mycosis showing aneurysmal dilation of the vessel (arrow). Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 16 Endoscopy of the pharynx of a horse with guttural pouch mycosis showing laryngeal hemiplegia and blood originating from the affected pouch. Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 17 Endoscopy of the guttural pouch of a horse showing a raised fungal plaque overlying the internal carotid artery (arrow). Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 18 Endoscopy of the guttural pouch of a horse showing a fungal plaque overlying the maxillary artery (arrow). Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 19 Endoscopy of the guttural pouch of a horse showing a fungal plaque (arrow) overlying an aberrant vessel in the medial compartment. (Courtesy of Peter Rakestraw, DMV, College Station, TX.) Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 20 (A) Endoscopy of the guttural pouch of a horse showing a fungal plaque on the median septum (arrow) with erosion of the median septum (arrowhead). (B) Same horse showing a fistula in the pharyngeal recess (arrow). Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 20 (A) Endoscopy of the guttural pouch of a horse showing a fungal plaque on the median septum (arrow) with erosion of the median septum (arrowhead). (B) Same horse showing a fistula in the pharyngeal recess (arrow). Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 21 Angiographic image showing the internal carotid and occipital arteries arising from a common trunk (arrow). Rostral is to the left. Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 22 Angiography showing correct placement of coils in the internal carotid artery. Complete occlusion is demonstrated by the failure to image contrast material past the coils (arrow). Rostral is to the left. Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 23 Angiography of the maxillary artery (arrowhead) showing the location of the superficial temporal artery (arrow). Rostral is to the left. Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 24 Angiography showing the location of the caudal auricular artery (arrow). Rostral is to the left. Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 25 Endoscopy of the right guttural pouch of a horse with longus capitis rupture. Note the submucosal hemorrhage on the median septum (arrow). Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 26 Lateral projection of the skull of a horse with longus capitis rupture. Note the opacification of the guttural pouch and an avulsion fracture of the attachment of the longus capitis muscle (arrow). Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 27 Illustration of a horse with stylohyoid arthropathy showing head tilt and facial nerve paralysis. Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 28 Endoscopy of the guttural pouch of a horse with stylohyoid arthropathy. Note the markedly enlarged caudal aspect of the stylohyoid bone (arrow). Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 29 Dorsoventral radiographic projection of the skull of a horse with stylohyoid arthropathy showing enlargement of the proximal aspect of the stylohyoid bone (arrow). Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)

Fig. 30 Lateral projection of the skull of a horse after stylohyoid ostectomy (accolade). Veterinary Clinics: Equine Practice 2003 19, 123-158DOI: (10.1016/S0749-0739(02)00070-6)