33rd Annual Scientific Meeting proceedings

Objectives: Employing laser to create salpingopharyngeal fistulae has been described previously to treat guttural pouch tympany, empyema and mycosis. Bilateral laser fenestration of guttural pouches led to resolution of fungal plaques and improvement of neurological deficits.

Methods: A 3-year old warmblood gelding was referred to the Equine Clinic at the University of Veterinary Sciences Brno with progressive oral dysphagia. Endoscopic examination revealed bilateral fungal plaques - affecting the glossopharyngeal and hypoglossal nerve in the left guttural pouch, and glossopharyngeal nerve only in the right guttural pouch. A standing procedure utilizing a trans-endoscopic diode laser fibre to fenestrate the dorsal pharyngeal recess was performed creating an opening into both guttural pouches. Fungal samples were obtained and cultivation revealed Aspergillus spp. Trans-endoscopic topical treatment with voriconazole was administered for 7 days postoperatively. Nasogastric tubing twice daily was necessary to prevent dehydration for the first ten days post-operatively.

Results: Endoscopic check-up showed significant signs of healing in the left guttural pouch, and no new fungal growth in the right one 30 days post-surgery. Six months post-surgery, salphingopharyngostomies were healed and both guttural pouches were free of mycotic plaques. Normal dietary management was possible 6 months post-operatively. Aeration via the iatrogenic salpingopharyngeal fistulae led to a complete resolution of the guttural pouch mycosis and subsequent improvement of the dysphagia.

Conclusion: Salpingopharyngostomy provides a promising alternative approach to treat guttural pouch mycosis when the fungal plaque is not associated with hemorrhage.