17:
336:. Diagnosis is achieved through radiography and endoscopic evaluation. The specific cause of guttural pouch tympany is not known, but it is suspected that it is more common when there are defects of the plica salpingopharyngeus, and/or the pharyngeal orifice where they act as a one-way valve that does not allow air to escape. Because of the risk of secondary infection, it is crucial that tympany be treated as soon as possible. Treatment protocols may include, but are not limited to, surgical intervention and in cases where surgery is not an option, insertion of a transnasal
210:
outwards, forming two types of vascular plexuses surrounding the internal carotid arteries: one with capillary bundles parallel to the internal carotid arteries in the outer layer of the tunica adventitia (outer peri-arterial plexus) and the other with vein-artery-vein triads within the inner layer of the tunica adventitia (inner peri-arterial plexus). These guttural pouch microvascular plexuses, engulfing the internal carotid arteries, are typical of
205:
that occurs during heavy exercise. However, this proven function has been called into question by another study that neither examined the guttural pouches nor the internal carotid arteries; and others have argued that a cooling function would require an unattainable high rate of inspiratory air flow
250:
infections can also occur. Some visible symptoms of guttural pouch disease include abnormal head and neck carriage, nasal discharge, painful swelling and occasional abnormal functioning of the structures associated with the pouch. Secondary problems may include inflammation of the middle ear due to
331:
Guttural pouch tympany is an uncommon ailment in which excessive amounts of air become trapped in the pouch, resulting in abnormal expansion. Tympany is usually unilateral, but in some cases can affect both pouches. It is seen most often in young foals and is more common in females than in males.
209:
The issue of necessary guttural pouch air flow rates, to provide rapid cooling of the internal carotid arteries, has been solved by further supporting evidence from microvascular studies of the guttural pouch mucosa. Many of the guttural pouch mucosal superficial arterioles and capillaries extend
200:
The function of the guttural pouches has been shown with experimental data to participate in the rapid cooling of arterial blood destined for the brain and surrounding structures. In other words, the horse's guttural pouches are 'brain-cooling devices', cooling blood within the internal carotid
322:
repeatedly until the exudate drains. Antimicrobial therapy without a lavage seldom remedies the infection. In more complex cases, where concretions have formed, surgical intervention may be necessary to ensure appropriate drainage and removal of the hardened material. The area can be accessed
283:, the infectious agent of strangles. Clinically apparent symptoms include painful swelling of the parotid area and recurrent infected nasal discharge, and in severe circumstances, difficulty breathing and abnormal head carriage may be observable. Fever, anorexia, difficulty swallowing and
121:
a mucosal fold at the caudal portion of the
Eustachian tube, forms an uninterrupted channel between the medial lamina of the Eustachian tube and the lateral wall of the pharynx. The plica salpingopharyngea can sometimes act as a one-way valve trapping air in the pouch, causing
225:
heat exchangers surrounding internal carotid arteries, and finally afterwards where the internal carotid arteries project upwards passing through the intracranial cavernous venous sinuses accepting cooled venous blood from the nasal sinuses.
266:
and mucosa, they have the potential to be affected by all respiratory pathogens. Most infections are self-limiting, requiring no or little medical intervention. Upon endoscopy, affected guttural pouches often house
16:
352:
currently and no predisposing factors have been identified. Fungal plaque is usually located in the medial guttural pouch, near the internal carotid artery. Clinical signs include unilateral or bilateral
971:
Perkins, Justin D.; Schumacher, Jim; Kelly, Ger; Gomez, Jorge H.; Schumacher, John (2006-10-01). "Standing surgical removal of inspissated guttural pouch exudate (chondroids) in ten horses".
314:
of the area will show an opaque fluid line in the pouch and if a retropharyngeal lymph node is involved, it may reveal a mass. In mild, acute cases of empyema, a saline or polyionic solution
63:. The condition predisposes young horses to infection, often including severe swelling and often requires surgery to correct. The guttural pouch is also the site of infection in equine
106:
The guttural pouches connect the middle ear to the pharynx. The opening into the pharynx is called the nasopharyngeal ostium, which is composed of the pharyngeal wall laterally and a
129:
Each pouch is moulded around the stylohyoid bone which divides the medial and lateral compartments. The medial compartment is much larger, and protrudes more caudally and ventrally.
332:
Tympany results in non-painful, soft swelling beneath the ear and behind the jaw. Additional symptoms may include roaring, difficulty breathing, and difficulty swallowing and/or
234:
If the drainage tract becomes blocked for any reason, the mucous secretions can accumulate and cause the pouch to distend, producing a visible and palpable protrusion behind the
957:
596:
214:
heat exchangers recognised in other animal species, supporting the data that guttural pouches participate in selective brain cooling, even at lower air flow rates.
538:
1146:
Caston, S. S.; Kersh, K. D.; Reinertson, E. L.; Cammack, S. (2015-01-01). "Treatment of guttural pouch tympany in foals with transnasal Foley catheter placement".
761:
Shane K. Maloney; Andrea Fuller; Graham
Mitchell; Duncan Mitchell (March 2002). "On the guttural pouch and selective brain cooling in equids: research letter".
251:
migration of the infection along the auditory tube; nasal bleeding caused by damage to the internal carotid artery; with vagus nerve involvement there may be
221:. The triad including the function of guttural pouches achieving arterial cooling, via both by utilizing inspiratory air cooling as well as microvascular
303:
in the pharyngeal orifices of the pouches. The infection can also be due to the rupture of the nearby retropharyngeal lymph nodes, usually caused by an
192:
passes ventral to the medial compartment before crossing to the lateral wall of the lateral compartment. The pouch also covers the temporohyoid joint.
937:
580:
137:
279:
Guttural pouch empyema is characterized by the accretion of purulent, bacteria infested exudate in the pouch. The bacteria is primarily
1192:
1182:
1078:
357:
due to erosion of the artery walls, nasal discharge and cranial nerve dysfunction. GPM is a dangerous condition as spontaneous fatal
1025:
287:
displacement may or may not be seen. Empyema is often secondary to guttural pouch tympany (distention of the pouches with air) in
501:
110:
fold medially. This opening leads to a short soft tissue passageway into the respective guttural pouch. The openings are located
404:
361:
can occur, usually within a few days to weeks after the first bout of epistaxis. The most common fungus associated with GPM is
144:; lymph nodules are also present. The compartments of each guttural pouch contain many important structures including several
100:
1068:
1015:
872:
111:
610:
Baptiste, Keith E.; Naylor, Jonathan M.; Bailey, Jeremy; Barber, Ernest M.; Post, Klass; Thornhill, Jim (2000-02-01).
92:
40:, and the American forest mouse. They are paired bilaterally just below the ears, behind the skull and connect to the
348:
Guttural pouch mycosis (GPM) is a fungal disease that is rare but potentially life-threatening. GPM is of unknown
382:
affected arteries. Early intervention is necessary to ensure the best chance of survival. Horses that experience
1347:
88:
900:
1352:
1337:
375:
370:
Diagnosis is made based on the history of the animal, presenting clinical signs and endoscopic exploration.
222:
211:
189:
177:
792:"Microvasculature of the Guttural Pouch Mucosa and Relationship With the Internal Carotid Artery in Horses"
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The guttural pouches are located behind the cranial cavity, caudally the skull and below the wings of the
96:
830:
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476:
333:
256:
371:
300:
1279:
1099:"Pharyngeal neuromuscular dysfunction associated with bilateral guttural pouch tympany in a foal"
951:
811:
712:
Mitchell, Graham; Fuller, Andrea; Maloney, Shane K; Rump, Nicola; Mitchell, Duncan (2006-09-22).
655:
590:
217:
This completes the triad of internal carotid artery cooling that protects the horse's brain from
47:
Due to the general inaccessibility of the pouches in horses, they can be an area of infection by
374:
is not suggested without coinciding surgery. Treatment typically consists of topical as well as
502:"The equine guttural pouch: Clinically relevant anatomy and basic treatment options for trauma"
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located between the ventral wall and pharynx. The left and right pouches are separated by the
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675:"A preliminary study on the role of the equine guttural pouches in selective brain cooling"
161:
116:
103:
muscles dorsomedially. Below these muscles, the two pouches fuse to form a median septum.
91:
muscles. The ventral portion lies on the pharynx and beginning of the esophagus, with the
25:
539:"Diagnosing Guttural Pouch Disorders and Managing Guttural Pouch Empyema in Adult Horses"
252:
627:
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to enable drainage of mucus when the head is lowered and prevent fluid build-up. The
1321:
984:
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from the involvement of sympathetic nerves. Involvement of the facial nerve is rare.
255:(roaring) or difficulty swallowing (also if glossopharyngeal nerve is involved); and
80:
60:
48:
1283:
831:"Selective brain cooling in the horse during exercise and environmental heat stress"
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611:
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379:
349:
218:
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185:
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all cause a mucosal fold indent within the medial compartment, visible when viewed
846:
55:, and these infections can be extremely severe and hard to treat. The condition
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Dobesova, O.; Schwarz, B.; Velde, K.; Jahn, P.; Zert, Z.; Bezdekova, B. (2012).
311:
284:
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and arteries that lie directly against the pouch as they pass into and out of
133:
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1114:
992:
909:
643:
459:
446:
Pollock, P. J. (2007). "Diagnosis and management of guttural pouch mycosis".
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Perkins, Gillian A.; Pease, Anthony; Crotty, Erin; Fubini, Susan L. (2003).
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383:
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64:
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diverticula that contain between 300 and 600 ml of air. They are present in
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299:, in particular, are inclined to guttural pouch tympany, as many have a
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247:
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149:
41:
1267:
1159:
891:
520:
1252:"Guttural pouch mycosis in horses: a retrospective study of 28 cases"
635:
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or other forms of nerve dysfunction as a result of GPM have a poorer
315:
414:
37:
15:
288:
1014:
Lavoie, Jean-Pierre; Hinchcliff, Kenneth
William (2008-01-01).
477:"Guttural Pouches - Anatomy & Physiology - WikiVet English"
33:
310:
Diagnosis is established through and endoscopic examination.
873:"Equine guttural pouch empyema, why does it become chronic?"
714:"Guttural pouches, brain temperature and exercise in horses"
612:"Physiology - A function for guttural pouches in the horse"
1067:
Robinson, Norman Edward; Sprayberry, Kim A. (2009-01-01).
246:, the causative agent of strangles, is commonly involved.
1213:"The mystery of fungal infection in the guttural pouches"
378:
antifungal medication, paired with surgery to occlude or
829:
FF McConaghy; JR Hales; RJ Rose; DR Hodgson (Dec 1995).
575:. St. Louis, Missouri: Elsevier Inc. pp. 522–525.
571:
Dyce, Keith, M.; Wesing, C. J. G.; Sack, W. O. (2010).
790:
Ninomiya, Hiroyoshi; Kuwano, Atsutoshi (March 2019).
242:
may become contaminated with pathogens. The bacteria
188:
is in contact with the dorsal part of the pouch. The
1211:
Lepage, O. M.; Perron, M. F.; Cadoré, J. L. (2004).
1299:"Fungal Infections of the Guttural Pouch in Horses"
1017:Blackwell's Five-Minute Veterinary Consult: Equine
390:that those who have not exhibited those symptoms.
901:20.500.11820/02506108-4e72-4a2b-96fe-91637419cb5f
340:in an attempt to remodel the pharyngeal orifice.
1046:Fjeldborg, J.; Baptiste, Keith (2017-01-03).
8:
956:: CS1 maint: multiple names: authors list (
595:: CS1 maint: multiple names: authors list (
206:partly diverted into the guttural pouches.
323:surgically through the Viborg's triangle.
1122:
899:
871:Dixon, P. M.; James, O. A. (2016-12-01).
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737:
140:and ciliated containing mucus-secreting
1297:Kentucky Equine Research Staff (2013).
435:
318:is often performed via an endoscope or
262:As the guttural pouches are covered by
152:in the caudal aspect of the skull. The
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1184:Clinical Veterinary Advisor: The Horse
949:
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59:affects several breeds, including the
1311:– via Kentucky Equine Research.
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1053:. University of Copenhagen, Denmark.
946:– via Merck Veterinary Manual.
796:Journal of Equine Veterinary Science
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532:
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471:
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271:that is in the process of draining.
1070:Current Therapy in Equine Medicine
1048:"Diseases of the Guttural Pouches"
938:"Guttural Pouch Disease in Horses"
14:
985:10.1111/j.1532-950X.2006.00204.x
763:South African Journal of Science
1103:The Canadian Veterinary Journal
79:(C1). They are enclosed by the
573:Textbook of Veterinary Anatomy
1:
1229:10.1016/s1090-0233(03)00108-4
835:Journal of Applied Physiology
691:10.1016/S1090-0233(98)80009-9
1187:. Elsevier Health Sciences.
1181:Wilson, David (2010-11-28).
1073:. Elsevier Health Sciences.
847:10.1152/jappl.1995.79.6.1849
24:Guttural pouches are large,
20:Guttural pouch (labelled 97)
1148:Equine Veterinary Education
880:Equine Veterinary Education
673:Baptiste, Keith E. (1998).
509:Equine Veterinary Education
448:Equine Veterinary Education
93:retropharyngeal lymph nodes
1369:
1239:– via Research Gate.
1097:Bell, Chris (2017-01-11).
808:10.1016/j.jevs.2018.12.025
85:mandibular salivary glands
1020:. John Wiley & Sons.
500:Davis, J. Weston (2015).
405:Equine respiratory system
174:cranial cervical ganglion
460:10.2746/095777307X240162
372:Pharmaceutical treatment
312:Radiographic examination
101:rectus capitis ventralis
190:external carotid artery
117:plica salpingopharyngea
1217:The Veterinary Journal
730:10.1098/rsbl.2006.0469
679:The Veterinary Journal
344:Guttural Pouch Mycosis
338:Foley balloon catheter
327:Guttural Pouch Tympany
275:Guttural Pouch Empyema
264:respiratory epithelium
124:guttural pouch tympany
57:guttural pouch tympany
21:
19:
334:aspiration pneumonia
253:laryngeal hemiplegia
628:2000Natur.403..382B
973:Veterinary Surgery
281:Streptococcus equi
269:mucopurulent fluid
244:Streptococcus equi
108:fibrocartilaginous
22:
1268:10.1136/vr.100700
1256:Veterinary Record
1160:10.1111/eve.12244
936:Rush, Bonnie, R.
892:10.1111/eve.12707
622:(6768): 382–383.
582:978-1-4160-6607-1
523:– via AAEP.
521:10.1111/eve.12399
301:congenital defect
257:Horner's syndrome
172:leaving from the
170:sympathetic trunk
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481:en.wikivet.net
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1306:. Retrieved
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359:hemorrhaging
350:pathogenesis
347:
330:
309:
280:
278:
261:
233:
219:hyperthermia
216:
208:
203:hyperthermia
199:
186:facial nerve
168:nerves; the
142:goblet cells
131:
126:
123:
115:
105:
74:
56:
46:
23:
1262:(22): 561.
285:soft palate
166:hypoglossal
42:nasopharynx
1322:Categories
1308:2017-01-11
943:2017-01-11
549:: 966–973.
543:Compendium
486:2017-01-11
431:References
176:; and the
134:epithelium
87:, and the
1168:2042-3292
1115:0008-5286
993:0161-3499
952:cite news
910:2042-3292
802:: 84–89.
644:0028-0836
591:cite book
388:prognosis
384:dysphagia
355:epistaxis
293:weanlings
230:Pathology
162:accessory
112:rostrally
89:pterygoid
71:Structure
65:strangles
1303:EquiNews
1284:23565276
1276:23118043
1237:15158209
1133:17334035
1001:17026551
816:80962204
748:17148434
652:10667779
394:See also
380:embolise
376:systemic
320:catheter
297:Arabians
236:mandible
196:Function
150:foramina
53:bacteria
1333:Hyraxes
1328:Equidae
1124:1780239
855:8847243
739:1686210
699:9564267
660:4424682
624:Bibcode
305:abscess
248:Mycotic
240:exudate
81:parotid
38:hyraxes
32:, some
1282:
1274:
1235:
1191:
1166:
1131:
1121:
1113:
1077:
1024:
999:
991:
908:
853:
814:
746:
736:
697:
658:
650:
642:
616:Nature
579:
316:lavage
238:. The
184:. The
1280:S2CID
1051:(PDF)
876:(PDF)
812:S2CID
769:(3).
656:S2CID
505:(PDF)
415:Hyrax
289:foals
158:vagus
77:atlas
49:fungi
1272:PMID
1233:PMID
1189:ISBN
1164:ISSN
1129:PMID
1111:ISSN
1075:ISBN
1022:ISBN
997:PMID
989:ISSN
958:link
906:ISSN
851:PMID
744:PMID
695:PMID
648:PMID
640:ISSN
597:link
577:ISBN
291:and
164:and
132:The
99:and
83:and
51:and
34:bats
1264:doi
1260:171
1225:doi
1221:168
1156:doi
1119:PMC
981:doi
896:hdl
888:doi
843:doi
804:doi
771:hdl
734:PMC
726:doi
687:doi
683:155
632:doi
620:403
517:doi
456:doi
136:is
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