EQ Guttural Pouches

Question 1

Describe the guttural pouch

Answer 1

Air filled, mucosa lined outpouching of the auditory tubes

Question 2

Outline the structure of the guttural pouch

Answer 2

Separated into lateral and medial by the stylohyoid bone

Question 3

What structures are associated with the lateral compartment of the guttural pouch?

Answer 3

External carotid, maxillary artery, superficial temporal arteries, VII, X

Question 4

What structures are associated with the medial compartment of the guttural pouch?

Answer 4

Internal carotids, sympathetic nerves, cranial laryngeal nerves, longus capitus, ix, x, xi, xii

Question 5

What clinical signs may be presented with guttural pouch pathology?

Answer 5

Nervous dysfunction (horners, laryngeal paralysis, facial symmetry, dysphagia), swelling, dyspnoea, epistaxis/ nasal discharge

Question 6

Guttural pouch empyema

Answer 6

Purulent material/ chondroids - endoscopic removal/ flushing

Question 7

What important structure may be affected by guttural pouch mycosis?

Answer 7

Internal carotids - fatal haemorrhage

Question 8

Differential for acute vestibular signs (ataxia, head tilt) with facial nerve paralysis?

Answer 8

Temporohyoid osteoarthropathy - may see head shake/ ear rubbing first

Question 9

Chronic bony proliferation of the petrous temporal bone and stylohyoid bone leading to ankylosis.

Answer 9

Temporohyoid osteoarthropathy