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1.
The pharyngeal orifice of the equine auditory tube has not been adequately described. Its larger size andposition, further rostral within the nasopharynx compared with other species, cannot be easily explained, but could be important for the proposed brain-cooling function of the guttural pouches; however, unlike other species, it may not be the sole regulator of auditory tube aeration. A ‘second orifice’ (representing the final entrance to the auditory tube diverticulum) deserves recognition in performing a role in air exchange between the auditory tube, diverticulum and middle ear. The results of this investigation suggest that regular guttural pouch ventilation during resting respiration does not occur. Previous reports may reflect, at least in part, a misinterpretation of air pressure measurements within the guttural pouches and nasopharynx. Small decreases in simulated inspiratory pressure consistently caused the passive opening of both the pharyngeal orifice and pouch ostium in horse cadavers suggesting that an active counter process may exist in the live horse to maintain closure of the guttural pouch openings during rest and light exercise. Intrinsic tone of the stylopharyngeus and pterygopharyngeus muscles may be part of this active process. The investigation offers theoretical evidence that opening of the equine auditory tubes to ventilate the guttural pouch occurs in two different ways, active and passive. The active process has two stages: (1) opening of the pharyngeal orifices by simultaneous contractions of the levator and tensor veli palatini, and pterygopharyngeus muscles; then (2) opening of the pouchostia by contractions of dorsal portions of the palatopharyngeus muscles. The alternative passive route involves reduction in tone of the stylopharyngeus and pterygopharyngeus muscles accompanied by increased inspiratory pressure.  相似文献   

2.
OBJECTIVE: To identify features of guttural pouch (auditory tube diverticulum) empyema in horses and compare findings of uncomplicated guttural pouch empyema with guttural pouch empyema complicated by chondroids. DESIGN: Retrospective study. ANIMALS: 91 horses with guttural pouch empyema. PROCEDURE: Medical records of horses with guttural pouch empyema were reviewed. RESULTS: The most common owner complaint and abnormal finding was persistent nasal discharge. Chondroids were detected in 21% (19/91) of affected horses. Streptococcus equi was isolated from the guttural pouch in 14 of 44 horses; for Streptococcus spp, in vitro resistance to sulfadimethoxine and trimethoprim-sulfamethoxazole was detected. Retropharyngeal swelling and pharyngeal narrowing were significantly more prevalent in horses with chondroids, compared with horses with uncomplicated empyema. Ninety-three percent of affected horses were discharged from the hospital; at time of discharge, 66% had complete resolution of disease, 19% had improvement without resolution, and 15% did not have improvement. CONCLUSIONS AND CLINICAL RELEVANCE: Horses with persistent nasal discharge should be examined endoscopically for guttural pouch empyema. Treatment with lavage offers a good prognosis for resolution of uncomplicated guttural pouch empyema. Aggressive treatment with lavage and endoscopic snare removal of chondroids offers a good prognosis and may make surgical intervention unnecessary.  相似文献   

3.
CASE DESCRIPTION: A 6-year-old Appaloosa mare was examined because of inappetance, difficulty eating, and swelling and mucopurulent discharge in the right eye. CLINICAL FINDINGS: Results of a CBC and serum bio-chemical analysis revealed no important findings. Ophthalmologic examination revealed scarring and ulceration of the superficial layers of the cornea. Endoscopic examination of the upper portion of the respiratory tract and auditory tube diverticula (guttural pouches) revealed abnormal thickness of the right stylohyoid bone and a plaque suggestive of mycotic growth on the left internal carotid artery. Radiographic examination revealed right-sided otitis media. Temporohyoid osteoarthropathy in the right guttural pouch and mycosis in the left guttural pouch were diagnosed. TREATMENT AND OUTCOME: Ceratohyoidectomy of the right stylohyoid bone was performed, and the left internal carotid artery was occluded via placement of stainless steel spring embolization coils. The mare regained the ability to eat without difficulty and improved clinically for approximately 4 weeks. However, the mare returned to the medical center 53 days after surgery with left-sided Horner syndrome, atrophy of the right side of the tongue, and a 3-week history of dysphagia and weight loss. Endoscopic evaluation revealed progression of mycotic growth in the left guttural pouch. The mare was euthanatized. CLINICAL RELEVANCE: Although the mycotic lesion in the left guttural pouch was an incidental finding at the time of initial examination, the lesion progressed to cause dysphagia and Horner syndrome after occlusion of the left internal carotid artery, a treatment that is typically associated with resolution of guttural pouch mycosis. Arterial occlusion is not necessarily a reliable method of resolving guttural pouch mycosis.  相似文献   

4.
Two horses with chronic empyema of the auditory tube diverticulum (guttural pouch) were refractory to medical treatment; empyema was bilateral in 1 horse and unilateral in the other. Both horses were treated by fistulation of the cartilage of the pharyngeal orifice by use of a neodymium:yttrium-aluminum-garnet laser in a noncontact manner. To maintain patency of the fistulae, indwelling catheters were placed into the openings created by the laser. For both horses, long-term follow-up did not reveal complications, and both owners were satisfied with results of the procedure. The authors recommend this procedure for horses that are unresponsive to medical treatment for chronic guttural pouch empyema.  相似文献   

5.
An aberrant branch of the internal carotid artery was detected by angiography in a horse with guttural pouch (auditory tube diverticulum) mycosis after the distal portion of the artery had been occluded by use of a detachable latex balloon. A second balloon was placed to eliminate retrograde hemorrhage from the aberrant branch. The horse recovered and returned to its previous activity. Vascular anomalies of the internal carotid artery my be more common than expected, and have resulted in fatal complications during and after surgical treatment in guttural pouch mycosis. Intraoperative identification of vascular anomalies by use of angiography may avoid these fatal complications.  相似文献   

6.
An 11-year-old Thoroughbred mare presented for evaluation of severe, acute bilateral epistaxis of several hours’ duration. Endoscopic evaluation revealed active haemorrhage from the right guttural pouch and significant dorsal compression of the nasopharynx. Rapid and severe retropharyngeal swelling developed, prompting placement of a temporary tracheostomy. Guttural pouch mycosis was suspected and transarterial coil embolisation of the right internal carotid, external carotid and maxillary arteries was successfully performed. It was suspected that haemorrhage from the vasculature of the guttural pouch tracked caudally into the retropharyngeal region resulting in significant swelling, pharyngeal collapse and a severely compromised airway. Clinicians should be aware of this rare complication of guttural pouch epistaxis.  相似文献   

7.
Two horses were examined for compression of the pharynx from the dorsal pharyngeal wall. Neither horse had a patent opening of 1 of the guttural pouches. Radiography of the guttural pouch region revealed a retropharyngeal opacity that occluded 1 guttural pouch. Organisms were not isolated on bacteriologic culture of fluid obtained from the affected guttural pouch. Surgical exploration of the guttural pouch revealed the lining to be easily removeable by blunt dissection in 1 horse; however, the lining was more firmly attached and removal was not attempted in the second horse. A fenestration between the normal and affected guttural pouch was created in both horses to allow for drainage. The etiopathogenesis of the cyst in the guttural pouches is unknown.  相似文献   

8.
The objective of the present study was to analyse the importance of the influences of the sex, inbreeding coefficient and the additive genetic contribution to the occurrence of guttural pouch tympany in Arabian foals. Horses affected by guttural pouch tympany were ascertained in the Clinic for Horses, School of Veterinary Medicine Hannover. The data comprised 27 Arabian purebred foals with guttural pouch tympany. Of these 27 animals 22 were patients of the Clinic for Horses between 1994 and 2001 and 5 Arabian foals were sampled on the studs. Information on the pedigrees of these patients allowed us to sort in the affected foals into four families with a total of 276 animals. Female foals were more often affected by guttural pouch tympany. The difference was 11.9% in favour of female foals. The size of the inbreeding coefficient was not important for the occurrence of guttural pouch tympany. The heritability estimate for the frequency of guttural pouch tympany using a threshold model was 0.49 +/- 0.28. This is the first report that could show a genetic component responsible for guttural pouch tympany in foals.  相似文献   

9.
The domestic horse (Equus caballus) have the large symmetrical guttural pouches (the auditory tube diverticulum) formed by saccate bulge of the auditory tube. In this study, CT examination was carried out in the head of Przewalski's horse (Equus przewalskii), the only true wild horse living at present. As results of the examination, Przewalski's horse possessed the large symmetrical guttural pouches divided into medial and lateral compartments by the stylohyoid bone. Moreover, the right and left guttural pouches meet each other at the median part to form a thin septum. As CT sections get close to the part of the occipital condyle, the lateral compartment disappeared, and the medial compartment gradually became small toward the base of the skull. These results indicate that the nuchal-basal part of the medial compartment is not well-developed as compared with the domestic horse.  相似文献   

10.
The objective of the present study was to analyse the importance of the influences of sex, inbreeding coefficient, proportion of genes of the original breeds and the additive genetic contribution to the occurrence of guttural pouch tympany in foals belonging to German Warmblood breeds. Foals affected by guttural pouch tympany were ascertained in the Clinic of Horses, School of Veterinary Medicine Hannover. This data set comprised 22 German Warmblood foals with guttural pouch tympany, which were patients of the Clinic for Horses between 1994 and 2001. Information on the pedigrees and all available relatives of these patients allowed us to group the affected foals into five families with a total of 289 animals. Female foals were significantly more often affected by guttural pouch tympany. The difference was 16.6% in favour of female foals. The size of the inbreeding coefficient was not important for the occurrence of guttural pouch tympany. The proportion of the genes of the breeds Arabian, Thoroughbred and Trakehner were not significantly different from a randomly selected sample of 10% of foals born in the same birth years and the same region. The heritability estimates for the frequency of guttural pouch tympany using a threshold model was 0.81 +/- 0.16. This is the first report that could show a genetic component responsible for guttural pouch tympany in horses.  相似文献   

11.
OBJECTIVE: To describe removal of guttural pouch chondroids through a laser fenestrated mesial septum in a pony with an obstructed pharyngeal ostium of the left guttural pouch. STUDY DESIGN: Case report. ANIMALS: Pony. METHODS: Transendoscopic laser neodymium:yttrium aluminum garnet (Nd:YAG) fenestration of the mesial guttural pouch septum was made by contact method (bare fiber, 15-25 W, exposure time 4 seconds). Dissected tissue was removed by transendoscopic monopolar electrosurgery (loop electrode, cutting blade) and multiple chondroids of varying size were removed from the left guttural pouch through the fenestration. RESULTS: After removing all chondroids and repeated flushing of the left guttural pouch via the right side, inflammation of the guttural pouch membranes decreased remarkably. The pony was discharged with instructions for transendoscopic lavage once weekly and was reevaluated at 2 months. A permanent septal fenestration was observed and the pony was free of abnormal clinical signs and being used for carriage driving competitions. CONCLUSION: Nd:YAG laser fenestration of the mesial septum is an approach for access to guttural pouch chondroids. CLINICAL RELEVANCE: 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.  相似文献   

12.
An unusual case of a two year old gelding with severe unilateral epistaxis due to guttural pouch mycosis is reported. The lesion had spread to involve the dorso-medial aspects of the right guttural pouch and had formed a fistula between the dorsal pharyngeal recess and both the left and right guttural pouches. The diagnosis, surgical treatment and postoperative management are described.  相似文献   

13.
An Appaloosa gelding presented for a traumatic puncture wound of the head ventral to the base of his left ear, bilateral epistaxis and upper respiratory compromise. The horse did not exhibit dysphagia or cranial nerve deficits. The horse suffered bilateral oblique fractures of both stylohyoid bones due to the traumatic incident, diagnosed upon endoscopy of the guttural pouches. Treatment consisted of anti‐inflammatory medication, broad‐spectrum antibiotics, guttural pouch lavage and dietary management with soft feeds. At a one‐month follow‐up examination, endoscopic evaluation revealed a union at both stylohyoid bone fracture sites. Guttural pouch mycosis was diagnosed in the left guttural pouch on the lateral wall at the entrance of the lateral compartment. The guttural pouch mycosis was treated with a nystatin and gentamicin flush, followed by a course of oral fluconazole. At the 3‐month re‐evaluation, the guttural pouch mycosis had completely responded to treatment.  相似文献   

14.
OBJECTIVE: To evaluate the cytological and microbiological contents of guttural pouch washes of ten randomly selected horses restrained so as to prevent them lowering their heads, and to assess the possible effects on the guttural pouch environment in these horses. PROCEDURE: Cytological and microbiological studies were performed on guttural pouch washes of ten clinically normal horses restrained in a standing position so as to prevent them from lowering their heads below normal, as would happen during transportation on long journeys. They were restrained for 12 or 24 h and cytological, bacteriological and mycological findings in guttural pouch washes were recorded. RESULTS: The cytological gradings and neutrophil concentrations of guttural pouch washings were higher in horses that had their heads restrained for a longer period. Washings from these horses were more likely to contain cultivable bacteria and were the only washes yielding potentially pathogenic bacterial species. CONCLUSION: Variation in the cytological differential counts and bacterial cultures of guttural pouch lavages may be found in clinically normal horses which have had their heads restrained in an elevated position for periods from 12 to 24 h. This should be considered when examining this site and care must be taken when interpreting cytology of guttural pouch lavages in samples taken after transportation for more than 12 h. Restriction of head movement could also affect the normal pouch enviroment and predispose it to disease.  相似文献   

15.
Recently there has been increased awareness of the role of the carrier state in propagating Streptococcus equi var equi (S equi) infections (strangles), although the anatomical location of the organisms in chronic carriers has not been consistently established. This case report describes a chronic strangles outbreak in a riding school, that was monitored over six months by repeated clinical and endoscopic guttural pouch examinations. All asymptomatic horses that had positive S equi cultures on nasal swabs or guttural pouch lavages were found to have lesions in their guttural pouches. These lesions included empyema, chondroids and previously undescribed chronic discharging lesions on the floor of the medical compartment of the guttural pouches. These observations further support previous studies indicating the importance of investigating the guttural pouches in horses suspected to be asymptomatic carriers of this organism.  相似文献   

16.
Advances in the understanding of guttural pouch physiology and novel therapeutic approaches to mycotic infections in the horse are reviewed. It is suggested that the guttural pouches may contribute to the regulation of arterial blood temperature, cooling the circulation to the brain to below body temperature. Aspergillus spp. is the major organism found in a guttural pouch affected with mycosis but it is unclear why this agent becomes aggressive. Conventional therapy aims to prevent fatal haemorrhage and to treat any neurological lesions but it is desirable to try to prevent the disease. A technique consisting of inserting a transarterial coil into the internal carotid, external carotid and maxillary arteries in normal and affected horses has been reported to be rapid, safe and effective in occluding the arteries and in inducing regression of the mycotic lesions without adjunctive medical treatment. When faced with acute and uncontrollable epistaxis in the field, the most effective means to reduce haemorrhage is probably the occlusion of both common carotid arteries. However, how such arterial occlusions can result in the successful management of guttural pouch mycosis without antifungal medication remains a mystery.  相似文献   

17.
Three protracted outbreaks of strangles were investigated using endoscopic examination and a total of 14 asymptomatic carriers of Streptococcus equi were identified of which 13 showed evidence of carriage in the guttural pouch. Treatment was initiated to eliminate S. equi colonisation since these animals posed an infectious risk to susceptible horses. Two further horses were referred to us with severe guttural pouch pathology and from which S. equi was cultured, and treatment of these cases is also described. Treatment in the first instance was directed towards removal of gross guttural pouch pathology as seen on endoscopic examination. This was done with a combination of irrigation of the pouch with moderate to large amounts of saline, suction of fluid material and endoscopic manipulation of chondroids. Subsequently, antibiotic treatment was used to eliminate S. equi infection. All animals received systemic antibiotics, in some cases combined with topical antimicrobial treatment. Treatment was generally regarded as successful when the guttural pouches appeared normal and S. equi was not detected in nasopharangeal swabs and pouch lavages on 3 consecutive occasions. Successful treatment of one carrier required surgical intervention due to occlusion of both guttural pouch pharyngeal openings. Fourteen of 15 carriers were successfully treated by endoscopic removal of inflammatory material and antibiotic treatment, without surgical intervention. Five carriers originally given potentiated sulphonamide (33%) required further therapy with penicillin or ceftiofur, administered both systemically and topically, before S. equi infection and associated inflammation of the guttural pouches were eliminated.  相似文献   

18.
To clarify the functions of the equine guttural pouch, the distribution of various immunoglobulin isotypes and subisotypes in the guttural pouch mucosa were examined in healthy horses. IgGa was present in the mucosa of guttural pouch, mucosal lymph nodules and submucosal lymph nodules. IgM was scattered in the mucosal lymph nodules and in the germinal centers of the submucosal lymph nodules. IgGc was recognized only in the submucosal lymph nodules. These immunoglobulin isotypes and subisotypes were found in lymphocytes and plasma cells. On the other hand, IgA was detected in glandular epithelial cells and the surface layer of the mucosal epithelium, as well as in free cells. This finding suggests that IgA is secreted through the glandular epithelium. Based on the above findings, we conclude that the guttural pouch has phylactic ability.  相似文献   

19.
A 20-year-old pony mare was presented to the equine hospital with a ten-day history of dysphagia, regurgitation and coughing. An obstruction of the oesophagus was excluded via endoscopy, but the proximal oesophagus appeared to be distended and circular contractions were missing. A guttural pouch endoscopy revealed a single, black-mottled plaque on the pharyngeal ramus of the vagus nerve in the left guttural pouch, causing a local swelling of this nerve. The pharyngeal ramus seemed to be atrophic distal to the lesion. A biopsy was taken from the lesion and histopathological findings proved the reasonable suspicion of a guttural pouch mycosis with a high degree of purulent-necrotic inflammation and invasion of fungal hyphae. There were no signs of neoplasia, such as melanoma. Daily guttural pouch irrigations with a clotrimazole emulsion (20 g Canesten® Gyn4 solved in 500 ml water), led to a good recovery of the mucosa above the nerve. Periodic endoscopic examination of the left guttural pouch showed that local thickening and distal atrophy of this pharyngeal ramus did not improve, neither did the clinical symptoms. Due to progressive weight loss, acute respiratory distress and aspiration pneumonia, the 20-year-old pony mare unfortunately had to be euthanized three weeks after discharge. This case report emphasizes the enormous importance of a single nerve for the realization of the swallowing process. The one-sided loss of function of the pharyngeal branch of the vagal nerve cannot be compensated neither by the remaining ipsilateral nerves nor by the contralateral normal functioning glossopharyngeal and vagal nerves and thus inevitably leads to severe dysphagia.  相似文献   

20.
This case series describes a technique to treat guttural pouch tympany that may be useful to equine practitioners. The objective of this work is to describe the treatment technique, outcome, possible complications and benefits. Data from a retrospective case series obtained by records review and follow‐up with owners and referring veterinarians were used. Foley catheters were placed into the guttural pouch using endoscopic guidance via the nasal passage, the balloon inflated and the catheter sutured to the external nares under tension. Foals were treated successfully with this method and complications were minor. This treatment method is a viable, low‐cost option for guttural pouch tympany in foals.  相似文献   

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