Laser Fenestration of the Mesial Septum for Treatment of Guttural Pouch Chondroids in a Pony

Abstract

When guttural pouch empyema and/or chondroids is associated with adhesion of the pharyngeal ostium, laser fenestration of the mesial septum from the opposite guttural pouch should be considered as an alternative approach for access, rather than classic external surgical approaches.

Endoscopic assisted electro-cauterization to treat an acquired pharyngeal ostium stenosis in a horse: a case report

“…The endoscopic procedure does not require general anaesthesia for the patient, avoiding the complications often described for the other techniques (Gehlen and Ohnesorge, 2005), and it provides an easier and safer approach to the lesion compared with traditional methods. It is the authors' opinion that the good outcome observed in this clinical case was also due to the short period which had elapsed between the development of the stenosis and its diagnosis and treatment.…”

“…The endoscopic approach to guttural pouches is easy to perform but it may be obstructed when stenotic or fibrotic processes have occurred in the pharyngeal orifice. Stenosis of the pharyngeal orifice has been described in a few papers (Gehlen and Ohnesorge, 2005;Perkins et al, 2006). It is not a common disease but may complicate the treatment of empyema and it must be resolved in order for there to be complete recovery from pathological conditions.…”

“…However, when conservative treatment does not result in desirable outcomes, it is necessary to carry out surgical treatment, which can be performed in different ways: via a hyovertebrotomy (Schaaf et al, 2006), with the Whitehouse technique and modified Whitehouse technique (Gehlen and Ohnesorge, 2005;Perkins et al, 2006), with fistulation through the Viborg's triangle, and with the fenestration of the mesial guttural pouch septum (Perkins et al, 2006). However, these surgical techniques could result in complications, such as iatrogenic lesions of cranial nerves and subsequent neurological dysfunction, including dysphagia and/or cranial neuropathies (Perkins et al, 2006;Fogle et al, 2007).…”

“…Inflammatory processes of the guttural pouch can result in empyema, which is sometimes complicated by chondroids and exudate conglomerates. Moreover, chronic guttural pouch empyema may occasionally involve stenosis or complete closure of the pharyngeal ostium (Gehlen and Ohnesorge, 2005;Perkins et al, 2006).…”

Transendoscopic Laser Surgery to Correct Nasopharyngeal Obstruction Caused by Head Flexion in Horses

“…In guttural pouch tympany, redundant mucosal tissue of the plica salpingopharyngeus (salpingopharyngeal fold) of the nasopharyngeal orifice of the Eustachian tube can act as a one‐way valve causing air retention in the guttural pouch . Treatment of guttural pouch tympany includes fenestration of the median septum, enlargement of the nasopharyngeal orifice, or resection of the salpingopharyngeal fold . The tensor veli palatini muscles contract facilitating opening of the nasopharyngeal cartilage of the guttural pouch during swallowing .…”