Salpingopharyngeal fistula as a treatment for guttural pouch mycosis in seven horses.

Abstract

Guttural pouch mycosis (GPM) is a cause of nasal discharge, dysphagia and fatal haemorrhage in the horse. To report the complications and success of salpingopharyngeal fistulation in horses with GPM. We hypothesised that creating a direct static opening into the guttural pouch from the pharynx would cause a regression of fungal plaques due to a change in the guttural pouch environment and that this treatment would result in resolution of infection prior to secondary complications. Retrospective case series. The medical records of all horses diagnosed with GPM that were presented to New Bolton Center between the years 2006 and 2017 were examined retrospectively. Seven cases of guttural pouch mycosis treated with salpingopharyngostomy without other surgical intervention were included. Information collected included signalment, presenting complaint, which pouch was affected, size and location of the plaques, laryngeal and pharyngeal function, concurrent medical therapy, location of the fistula, surgical time, time to resolution of clinical signs, time to full resolution of the mycotic plaque, and patency of the salpingopharyngostomy site. Nasal discharge resolved in 10-30 days post-operatively in all cases where nasal discharge was present. The mycotic plaques showed complete resolution at time points ranging from 1 to 6 months post-operatively. No case developed epistaxis or neurological deficits post-operatively that were not present at presentation. There were differing adjunctive treatments between cases. This technique is not appropriate for horses that have had epistaxis or are currently bleeding. Salpingopharyngostomy can minimise cost of treatment, be performed on an outpatient basis and provide better exposure of the infected area with few complications. This case series documents seven cases treated with this method that resolved the infection without any further complications of the mycosis.