disease of the guttural pouch

Question 1

what are the guttural pouches

Answer 1

Air-filled, mucosa lined
outpouchings of the auditory
tubes connecting the
nasopharynx to the middle ear

Question 2

what is the flap that connects the guttural puch to the nasopharynx called and when does it open

Answer 2

the otium

opens when swallowing

Question 3

what seperates the guttural pouch into medial and lateral compartments

Answer 3

the stylohyoid bone

Question 4

what structures are associated with the guttural pouch

Answer 4

internal + external carotid arteries
cranial nerves 9,10,11,12
stylohyoid bones and temporohyoid articulation

Question 5

What is guttural pouch mycosis

Answer 5

fungal plaque forms over artery (internal carotid usually) (asperigillus spp)

Question 6

is guttural pouch mycosis serious

Answer 6

YES!

severe epistaxis

Question 7

how would you diagnose GPM

Answer 7

endoscopy. see blood flowing out of otium.

do not enter guttural pouch with endoscope as may disrupt clot

Question 8

how would you surgically treat GPM

Answer 8

occlude affected arteries by ligation.
balloon catherisation
systemic or topical antifungal after surgery

Question 9

what is another cause that may cause blood to flow out of guttural pouch?

Answer 9

rectus capitis or rectus longus muscle rupture

usually occurs after trauma

Question 10

what are the differentials for dysphagia

Answer 10

obstruction
retropharyngeal masses

neurological:
guttural pouch mycosis
GP empyaema/inflammation
grass sickness
botulism, tetanus
rabies

Question 11

Guttural pouch empyema

Answer 11

purulent material in pouches.

chondroids if they solidify

Question 12

what are the clinical signs of GP empyaema

Answer 12

purulent nasal discharge
lymph node enlargment
dyspnoea, dysphagia

(always rule in/out strangles)

Question 13

how would you treat GP empyema

Answer 13

endoscopic lavage

if chondroids present:
endoscopic assisted removal
laser assisted techniques
direct surgical approach

Question 14

what is it called when air is trapped in the guttural pouch

Answer 14

guttural pouch tympany

Question 15

who is GP tympany most commonly seen in and how would you treat

Answer 15

seen in foals up to 1 years old

treat with cathaterisation

Question 16

what are the clinical signs of GP tympany

Answer 16

marked retropharyngeal swelling
respiratory stridor
dysphagia

Question 17

what is a temorohyoid osteoarthropathy

Answer 17

progressive disease of the middle ear/temporohyoid joint

Question 18

what is the sequalae of temorohyoid osteoarthropathy

Answer 18

fusion of bone

if bone fractures later can cause cranial nerve damage (7,8)

Question 19

clinical signs of osteoarthropathy

Answer 19

head shaking, ear rubbing
facial nerve signs
secondary ocular disease
vestibular signs (head tilt)

Question 20

what is the most common GP neoplasia

Answer 20

melanoma in grey horses

Question 21

How to perform a tracheostomy

Answer 21

clip and wash skin
inject 10ml local anaesthetic
vertical incision through skin
horizontal incision through rings (no more than 1/3 circumfrance)
guide tube in and secure in place