Salpingopharyngeal fistula as a treatment for guttural pouch mycosis in seven horses

Abstract

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.

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

“…How much the size of the fenestrations will decrease with healing or whether a predictable patency can be achieved is unknown. Previous work has shown that while some fenestration sites heal, others remain patent on follow-up [ 6 7 19 ]. One study hypothesized that fenestration within the guttural pouch can alter the local environment triggering the resolution of mycosis [ 19 ].…”

“…Previous work has shown that while some fenestration sites heal, others remain patent on follow-up [ 6 7 19 ]. One study hypothesized that fenestration within the guttural pouch can alter the local environment triggering the resolution of mycosis [ 19 ]. Despite these questions, it is apparent that diverticulotomy is therapeutic when applied to selected primary diseases of the guttural pouch, including tympany, empyema, and chondroids [ 7 9 ].…”

“…There are apparent advantages and disadvantages of transendoscopic laser auditory tube diverticulotomy. Advantages of a transpharyngeal minimally invasive approach over transcutaneous open approaches include reduced risk of iatrogenic cranial nerve damage, avoidance of postoperative wound maintenance by horse caregivers, and requirement of light sedation to complete the procedure [ 6 7 17 19 ]. However, disadvantages include the need for specialized equipment and the loss of endoscopic visualization due to hemorrhage, which can occur with laser surgery of the upper respiratory tract [ 3 6 7 ].…”

“…Chronic infection of auditory tube diverticula, and subsequent empyema and chondroid formation, is well described in the horse [ 9 10 ]. Variable success has been reported with medical therapy [ 1 13 19 ]. Treatment failures have been attributed to chronic inflammation and inadequate drainage from the nasopharyngeal ostium of the auditory tube [ 7 ].…”

Highlights of recent clinically relevant papers

“…This retrospective clinical report by Amanda Watkins and Eric Parente , based at the University of Pennsylvania in the USA, describes the use and outcome of transendoscopic laser salpingopharyngostomy for treatment of guttural pouch mycosis (GPM) in horses .…”