Salpingopharyngeus fistula by means of videosurgery to treat horse bilateral gutural pouch chronic empyema – a case study / Fístula salpingofaríngea por videocirurgia para tratamento de empiema crônico de bolsa gutural bilateral em equino – relato de caso

The aim of this paper is to report the Salpingopharyngeus fistula technique by means of videosurgery through a natural orifice (NOTES) in order to treat bilateral empyema. A mare was seen at the Large Animal Sector of UFPR, with a history of bilateral purulent nasal discharge associated with dysphagia lasting for ninety days. The animal was submitted to endoscopy, showing a moderate amount of purulent secretion in both guttural pouches. With no improvement on the clinical treatment, we opted for surgical treatment by endoscopy through Salpingopharyngeus fistula made with the aid of a device containing an electrical scalpel developed to perform this technique. It consisted of making an incision in the pharyngeal recess in order to access the guttural pouches and subsequently drain the purulent content. The patient was discharged at the same day and returned to work 30 days after the procedure. Surgical treatment for cases of guttural pouch empyema is indicated when the clinical resolution has not been effective, and the minimally invasive technique is indicated due to the reduction of risks and the easiness of postoperative management. Until this moment, there are no reports of the salpingopharyngeal fistula technique through video surgery for the treatment of guttural pouch empyema, which has proved to be efficient for the treatment of the disease.

O objetivo deste trabalho é relatar a técnica de fístula salpingofaríngea por videocirurgia através de orifício natural (NOTES) para tratamento de empiema bilateral. Uma égua foi atendida no Setor de Grandes Animais da UFPR, com histórico de secreção nasal purulenta bilateral associado a disfagia há noventa dias. O animal foi submetido à endoscopia, evidenciando moderada quantidade de secreção purulenta em ambas as bolsas guturais. Sem apresentar melhora com o tratamento clínico, optou-se pelo tratamento cirúrgico por endoscopia através da realização de uma fístula salpingofaríngea feita com o auxílio de um dispositivo contendo eletrobisturi, desenvolvido para a realização desta técnica; que consistiu na realização de uma incisão no recesso faríngeo, para o acesso das bolsas guturais e posterior drenagem do conteúdo purulento. O paciente recebeu alta médica no mesmo dia e retornou ao trabalho 30 dias após o procedimento. O tratamento cirúrgico para os casos de empiema de bolsa gutural é indicado quando a resolução clínica não foi efetiva, sendo a técnica minimamente invasiva indicada devido à redução de riscos e à facilidade do manejo pós-operatório. Até o momento, não há relatos da técnica de fístula salpingofaríngea através de videocirurgia para o tratamento de empiema de bolsa gutural, a qual mostrou-se eficiente para o tratamento da enfermidade.

Salpingopharyngeus fistula by means of videosurgery to treat horse bilateral gutural pouch chronic empyema a case study / Fístula salpingofaríngea por videocirurgia para tratamento de empiema crônico de bolsa gutural bilateral em equino relato de caso

The aim of this paper is to report the Salpingopharyngeus fistula technique by means of videosurgery through a natural orifice (NOTES) in order to treat bilateral empyema. A mare was seen at the Large Animal Sector of UFPR, with a history of bilateral purulent nasal discharge associated with dysphagia lasting for ninety days. The animal was submitted to endoscopy, showing a moderate amount of purulent secretion in both guttural pouches. With no improvement on the clinical treatment, we opted for surgical treatment by endoscopy through Salpingopharyngeus fistula made with the aid of a device containing an electrical scalpel developed to perform this technique. It consisted of making an incision in the pharyngeal recess in order to access the guttural pouches and subsequently drain the purulent content. The patient was discharged at the same day and returned to work 30 days after the procedure. Surgical treatment for cases of guttural pouch empyema is indicated when the clinical resolution has not been effective, and the minimally invasive technique is indicated due to the reduction of risks and the easiness of postoperative management. Until this moment, there are no reports of the salpingopharyngeal fistula technique through video surgery for the treatment of guttural pouch empyema, which has proved to be efficient for the treatment of the disease.(AU)

O objetivo deste trabalho é relatar a técnica de fístula salpingofaríngea por videocirurgia através de orifício natural (NOTES) para tratamento de empiema bilateral. Uma égua foi atendida no Setor de Grandes Animais da UFPR, com histórico de secreção nasal purulenta bilateral associado a disfagia há noventa dias. O animal foi submetido à endoscopia, evidenciando moderada quantidade de secreção purulenta em ambas as bolsas guturais. Sem apresentar melhora com o tratamento clínico, optou-se pelo tratamento cirúrgico por endoscopia através da realização de uma fístula salpingofaríngea feita com o auxílio de um dispositivo contendo eletrobisturi, desenvolvido para a realização desta técnica; que consistiu na realização de uma incisão no recesso faríngeo, para o acesso das bolsas guturais e posterior drenagem do conteúdo purulento. O paciente recebeu alta médica no mesmo dia e retornou ao trabalho 30 dias após o procedimento. O tratamento cirúrgico para os casos de empiema de bolsa gutural é indicado quando a resolução clínica não foi efetiva, sendo a técnica minimamente invasiva indicada devido à redução de riscos e à facilidade do manejo pós-operatório. Até o momento, não há relatos da técnica de fístula salpingofaríngea através de videocirurgia para o tratamento de empiema de bolsa gutural, a qual mostrou-se eficiente para o tratamento da enfermidade.(AU)

Outcome of a ceratohyiodectomy in a criollo mare with temporohyoid osteoarthropathy

Background: Temporohyoid osteoarthropathy (THO) is a progressive disease that causes acute onset of peripheral vestibular signs with or without facial paralysis. Ankylosis of temporhyoid joint occurs which predispose to fractures of theinvolved bones and consequently causes the commonly neurological signs observed. Clinical signs vary depending on thestage of the disease and the nerves affected. Surgical treatment is advised to improve survival rates in which the ceratohyoidectomy is currently known as the most advantageous. The aim of the present study is to report a case and outcome ofa ceratohyoidectomy procedure in a Criollo mare presenting THO of the right temporohyoid joint.Case: A 17-year-old Criollo mare was referred to the Equine Clinical Hospital of the Federal University of Pelotas witha 5-day history of facial paralysis on the right side, head tilt and difficulty to chew and swallow. Auricular, palpebraland labial ptosis along with deviation of the lip and nostril to the left were observed. A corneal ulcer was also identifiedin the right eye. Complementary imaging exams (endoscopy of the guttural pouches and radiography of the head) wereperformed and showed thickening of the right stylohyoid bone confirming a diagnosis of THO. Anti-inflammatory andantibiotic therapy were administered and the corneal ulcer was treated with topical antibiotics and autologous serum. Dueto rapid deterioration of clinical signs, the mare was referred to surgery. A ceratohyoidectomty procedure was performedunder general anesthesia. In this procedure, the ceratohyoid bone was disarticulated from the ceratohyoid-basihyoid jointand removed. During the procedure, a branch of the linguofacial vein was accidentally incised causing hemorrhage, thebranch was identified and successfully ligated. Recovery was uneventful. Supportive treatment with anti-inflammatory andantibiotics was continued after surgery and ...

Outcome of a ceratohyiodectomy in a criollo mare with temporohyoid osteoarthropathy

Background: Temporohyoid osteoarthropathy (THO) is a progressive disease that causes acute onset of peripheral vestibular signs with or without facial paralysis. Ankylosis of temporhyoid joint occurs which predispose to fractures of theinvolved bones and consequently causes the commonly neurological signs observed. Clinical signs vary depending on thestage of the disease and the nerves affected. Surgical treatment is advised to improve survival rates in which the ceratohyoidectomy is currently known as the most advantageous. The aim of the present study is to report a case and outcome ofa ceratohyoidectomy procedure in a Criollo mare presenting THO of the right temporohyoid joint.Case: A 17-year-old Criollo mare was referred to the Equine Clinical Hospital of the Federal University of Pelotas witha 5-day history of facial paralysis on the right side, head tilt and difficulty to chew and swallow. Auricular, palpebraland labial ptosis along with deviation of the lip and nostril to the left were observed. A corneal ulcer was also identifiedin the right eye. Complementary imaging exams (endoscopy of the guttural pouches and radiography of the head) wereperformed and showed thickening of the right stylohyoid bone confirming a diagnosis of THO. Anti-inflammatory andantibiotic therapy were administered and the corneal ulcer was treated with topical antibiotics and autologous serum. Dueto rapid deterioration of clinical signs, the mare was referred to surgery. A ceratohyoidectomty procedure was performedunder general anesthesia. In this procedure, the ceratohyoid bone was disarticulated from the ceratohyoid-basihyoid jointand removed. During the procedure, a branch of the linguofacial vein was accidentally incised causing hemorrhage, thebranch was identified and successfully ligated. Recovery was uneventful. Supportive treatment with anti-inflammatory andantibiotics was continued after surgery and ...(AU)

Non-surgical treatment of guttural pouch empyema with presence of chondroids in a filly

Background: Guttural pouch empyema in horses is a disease described by the accumulation of purulent/mucopurulent exudate, which with chronification of the disease can become chondroids, affecting horses of any age and not presenting breed predisposition. The main cause of empyema is upper respiratory infection, associated or not with failure in the defense mechanisms, as well as drainage to the guttural pouch of retropharyngeal lymph node abscesses; the main pathogen related to this condition is Streptococcus equi. This paper aims to describes a case of a filly that presented a mucopurulent nasal discharge, five months of evolution, and irresponsive to antibiotic therapy. Case: A 2.5-year-old quarter filly was referred to the veterinary hospital presenting a 5 months evolution mucopurulent nasal discharge, irresponsive to gentamicin and ceftiofur, and later doxycycline, acetylcysteine and clenbuterol that were instituted on the farm. Throw the endoscopic examination of the upper respiratory tract, was observed the presence of mucopurulent content and chondroids inside the right guttural pouch. This material was collected and sent for culture and antibiogram tests. Streptococcus equi was isolated, and was only sensitive to ceftiofur. The treatment included the guttural pouches flushes with warm saline solution (0.9%) associated with Lauryl Dietylene Glycol Ether Sulfate Sodium (28%) and acetylcysteine (10%). In addition to topical treatment, 5 mg/kg of ceftiofur was administered intramuscularly daily for 7 days. After 10 flushes of the guttural pouch, was observed a total absence of chondroid and mucopurulent contents. Discussion: The treatment of the guttural pouch empyema can be performed either by conservative methods or by the surgical drainage. Among the benefits of the conservative treatment are the absence of the risks...

Non-surgical treatment of guttural pouch empyema with presence of chondroids in a filly

Background: Guttural pouch empyema in horses is a disease described by the accumulation of purulent/mucopurulent exudate, which with chronification of the disease can become chondroids, affecting horses of any age and not presenting breed predisposition. The main cause of empyema is upper respiratory infection, associated or not with failure in the defense mechanisms, as well as drainage to the guttural pouch of retropharyngeal lymph node abscesses; the main pathogen related to this condition is Streptococcus equi. This paper aims to describes a case of a filly that presented a mucopurulent nasal discharge, five months of evolution, and irresponsive to antibiotic therapy. Case: A 2.5-year-old quarter filly was referred to the veterinary hospital presenting a 5 months evolution mucopurulent nasal discharge, irresponsive to gentamicin and ceftiofur, and later doxycycline, acetylcysteine and clenbuterol that were instituted on the farm. Throw the endoscopic examination of the upper respiratory tract, was observed the presence of mucopurulent content and chondroids inside the right guttural pouch. This material was collected and sent for culture and antibiogram tests. Streptococcus equi was isolated, and was only sensitive to ceftiofur. The treatment included the guttural pouches flushes with warm saline solution (0.9%) associated with Lauryl Dietylene Glycol Ether Sulfate Sodium (28%) and acetylcysteine (10%). In addition to topical treatment, 5 mg/kg of ceftiofur was administered intramuscularly daily for 7 days. After 10 flushes of the guttural pouch, was observed a total absence of chondroid and mucopurulent contents. Discussion: The treatment of the guttural pouch empyema can be performed either by conservative methods or by the surgical drainage. Among the benefits of the conservative treatment are the absence of the risks...(AU)

Glossopharyngeal and vagus neuropathy associated to stylopharyngeus muscle compression in horse guttural pouch ­ case report / Neuropatia do glossofaringeo e vago associada à compressão pelo musculo estilofaringeo em bolsa gutural de equino ­ relato de caso

Neuropathies of pharyngeal branches of glossopharyngeal and vagus are often associated with guttural pouches diseases; however, these branches of injury due to stylopharyngeus muscle compression are not reported. A case was reported of a quarter horse mare, 8 years old, 450 kg, presenting dyspnea and respiratory noise associated with weight loss. Clinical examination observed mixed dyspnea, tachycardia, dysphagia, sialorrhea, lung crackles and submandibular and parotid lymphadenopathy. Endoscopic exam showed right arytenoid chondritis, nasopharyngeal collapse, generalized larynx edema and dorsal displacement of the soft palate. Right guttural pouch evaluation showed swelling in the origin of stylopharyngeus muscle with consequent compression of the XII, X and IX cranial nerves. Tracheotomy, systemic treatment with corticosteroids, beta lactams and aminoglycosides antibiotics were performed. No resolution was observed and, after 16 days, the animal showed clinical worsening, developed pleuropneumonia, uveitis, severe sepsis, acute renal failure and was euthanized. The mixed neuropathy resulted in rapid clinical deterioration of the animal, due to the difficulty in swallowing and consequent associated respiratory processes. This report emphasizes the importance of evaluating stylopharyngeus muscle origin in cases of nasopharyngeal collapse associated with dysphagia in horses, given the possibility that structural changes in this muscle can result in laryngeal neuropathy.(AU)

As neuropatias do glossofaríngeo e vago são frequentemente associadas com enfermidade das bolsas guturais. A ocorrência desta lesão secundária a compressão pelo músculo estilofaríngeo não é reportada. Relata-se o caso de uma égua quarto de milha, 8 anos de idade, 450 kg, apresentando dispneia, ruído respiratório e perda de peso. No exame clínico observou-se dispnéia mista, taquicardia, disfagia, sialorréia, crepitação pulmonar e linfadenopatia submandibular e parotídea. Ao exame endoscópico identificou-se condrite aritenóide direita, colapso nasofaríngeo, edema generalizado da laringe e deslocamento dorsal do palato mole. Na avaliação da bolsa gutural direita identificou-se aumento de volume na origem do músculo estilofaríngeo com consequente compressão dos nervos cranianos XII, X e IX. Foi realizada traqueotomia, tratamento sistêmico com corticosteróides e antibióticos. Nenhuma resolução foi observada, após 16 dias o animal apresentou piora clínica, pleuropneumonia, uveíte, sepse grave, insuficiência renal aguda e foi submetido à eutanásia. A neuropatia mista resultou em rápida deterioração clínica do animal, devido à dificuldade de deglutição e processos respiratórios associados. Salienta-se a importância de se avaliar a origem do músculo estilofaríngeo em casos de colapso nasofaríngeo associado a disfagia em cavalos, dada a possibilidade de que alterações estruturais nesse músculo possam resultar em neuropatia laríngea.(AU)

Glossopharyngeal and vagus neuropathy associated to stylopharyngeus muscle compression in horse guttural pouch ­ case report / Neuropatia do glossofaringeo e vago associada à compressão pelo musculo estilofaringeo em bolsa gutural de equino ­ relato de caso

Neuropathies of pharyngeal branches of glossopharyngeal and vagus are often associated with guttural pouches diseases; however, these branches of injury due to stylopharyngeus muscle compression are not reported. A case was reported of a quarter horse mare, 8 years old, 450 kg, presenting dyspnea and respiratory noise associated with weight loss. Clinical examination observed mixed dyspnea, tachycardia, dysphagia, sialorrhea, lung crackles and submandibular and parotid lymphadenopathy. Endoscopic exam showed right arytenoid chondritis, nasopharyngeal collapse, generalized larynx edema and dorsal displacement of the soft palate. Right guttural pouch evaluation showed swelling in the origin of stylopharyngeus muscle with consequent compression of the XII, X and IX cranial nerves. Tracheotomy, systemic treatment with corticosteroids, beta lactams and aminoglycosides antibiotics were performed. No resolution was observed and, after 16 days, the animal showed clinical worsening, developed pleuropneumonia, uveitis, severe sepsis, acute renal failure and was euthanized. The mixed neuropathy resulted in rapid clinical deterioration of the animal, due to the difficulty in swallowing and consequent associated respiratory processes. This report emphasizes the importance of evaluating stylopharyngeus muscle origin in cases of nasopharyngeal collapse associated with dysphagia in horses, given the possibility that structural changes in this muscle can result in laryngeal neuropathy.(AU)

As neuropatias do glossofaríngeo e vago são frequentemente associadas com enfermidade das bolsas guturais. A ocorrência desta lesão secundária a compressão pelo músculo estilofaríngeo não é reportada. Relata-se o caso de uma égua quarto de milha, 8 anos de idade, 450 kg, apresentando dispneia, ruído respiratório e perda de peso. No exame clínico observou-se dispnéia mista, taquicardia, disfagia, sialorréia, crepitação pulmonar e linfadenopatia submandibular e parotídea. Ao exame endoscópico identificou-se condrite aritenóide direita, colapso nasofaríngeo, edema generalizado da laringe e deslocamento dorsal do palato mole. Na avaliação da bolsa gutural direita identificou-se aumento de volume na origem do músculo estilofaríngeo com consequente compressão dos nervos cranianos XII, X e IX. Foi realizada traqueotomia, tratamento sistêmico com corticosteróides e antibióticos. Nenhuma resolução foi observada, após 16 dias o animal apresentou piora clínica, pleuropneumonia, uveíte, sepse grave, insuficiência renal aguda e foi submetido à eutanásia. A neuropatia mista resultou em rápida deterioração clínica do animal, devido à dificuldade de deglutição e processos respiratórios associados. Salienta-se a importância de se avaliar a origem do músculo estilofaríngeo em casos de colapso nasofaríngeo associado a disfagia em cavalos, dada a possibilidade de que alterações estruturais nesse músculo possam resultar em neuropatia laríngea.(AU)

Epistaxes: um desafio para o clínico na busca do prognóstico / Epistaxis: a challenge for clinicians in the search for prognosis

Background: Ailments that affect guttural pouches (GPs) include congenital malformations, tumors, and, especially, infections. Clinical signs of disorders of the GPs are not always specific, and include nasal secretion, epistaxis, and enlargement of regional lymph nodes. Deficient diagnosis and treatment tend to limit life expectancy. Some cases can lead to terminal exsanguination due to progression of the disorder if not diagnosed or if treatment fails. Unusual presentations may occur, and these cases require knowledge for prompt action and determination of the prognosis. The objective of this work is to report one of these unusual cases: epistaxis caused by rupture of the GP by a pharyngeal abscess.Case: A 6-year-old mare was presented for examination exhibiting purulent nasal secretion that had been ongoing for approximately 45 days (which had been treated as strangles for 7 days) and intermittent epistaxis for the past 20 days. When the mare was taken to the Veterinary Hospital, it also exhibited dysphagia with purulent nasal secretion mixed with the ingested food, a body condition score of 3/9, wheezing, mild ataxia, anemia (2.8 million RBCs/mm3 ; hematocrit = 14%), leukopenia (4,600 WBCs/mm3), and hyperfibrinogenemia (600 mg/dL). Upper airway endoscopy revealed presence of blood in the anterior third of the trachea, a blood clot in the left GP, and absence of bacterial of fungal plaques. Analysis of the bloody material collected from the GP showed presence of cocci bacteria and neutrophils. The treatment initially implemented was antibiotic therapy with enrofloxacin. Epistaxis worsened on the day following admission. Blood transfusion was carried out, but this procedure was not effective as profuse acute hemorrhage took place and led to death of the patient 48 h after admission. At necropsy, the left GP was laden with blood clots and serous/bloody content, and exhibited a circular/cylindrical lesion in its retropharyngeal portion.[...]

Epistaxes: um desafio para o clínico na busca do prognóstico / Epistaxis: a challenge for clinicians in the search for prognosis

Background: Ailments that affect guttural pouches (GPs) include congenital malformations, tumors, and, especially, infections. Clinical signs of disorders of the GPs are not always specific, and include nasal secretion, epistaxis, and enlargement of regional lymph nodes. Deficient diagnosis and treatment tend to limit life expectancy. Some cases can lead to terminal exsanguination due to progression of the disorder if not diagnosed or if treatment fails. Unusual presentations may occur, and these cases require knowledge for prompt action and determination of the prognosis. The objective of this work is to report one of these unusual cases: epistaxis caused by rupture of the GP by a pharyngeal abscess.Case: A 6-year-old mare was presented for examination exhibiting purulent nasal secretion that had been ongoing for approximately 45 days (which had been treated as strangles for 7 days) and intermittent epistaxis for the past 20 days. When the mare was taken to the Veterinary Hospital, it also exhibited dysphagia with purulent nasal secretion mixed with the ingested food, a body condition score of 3/9, wheezing, mild ataxia, anemia (2.8 million RBCs/mm3 ; hematocrit = 14%), leukopenia (4,600 WBCs/mm3), and hyperfibrinogenemia (600 mg/dL). Upper airway endoscopy revealed presence of blood in the anterior third of the trachea, a blood clot in the left GP, and absence of bacterial of fungal plaques. Analysis of the bloody material collected from the GP showed presence of cocci bacteria and neutrophils. The treatment initially implemented was antibiotic therapy with enrofloxacin. Epistaxis worsened on the day following admission. Blood transfusion was carried out, but this procedure was not effective as profuse acute hemorrhage took place and led to death of the patient 48 h after admission. At necropsy, the left GP was laden with blood clots and serous/bloody content, and exhibited a circular/cylindrical lesion in its retropharyngeal portion.[...](AU)

Evaluation of the healing process in medial septum fenestration of the guttural pouch in the horse / Avaliação dos processos de cicatrização da fenestração do septo-medial da bolsa gutural em eqüinos

The guttural pouch tympany is characterized by a painless distension of the parotid region, frequently severe enough to displace the pharynx and trachea and to compress the contralateral guttural pouch. In timpanites of the guttural pouches, surgical access is achieved through Viborg"s triangle, an attempt to establish a communication between the affected and the normal guttural pouches through a fenestration in the medium wall between them. The objective of this study was to observe the time necessary from the incision to produce the fenestration until the complete healing, as well as the post-surgical scarring phenomena such as evolution of local reactions, formation of granulation tissue, neovascularization, scarring degree along time, and to observe the formation or not of interguttural stoma.

O timpanismo de bolsa gutural caracteriza-se por uma distensão indolor da região parotídea, frequentemente severa o bastante para deslocar a faringe e a traquéia, e comprimir a bolsa gutural contralateral. A bolsa gutural pode ser acessada cirurgicamente, em casos de timpanismo, através do triângulo de Viborg. Essa cirurgia consiste em se estabelecer uma comunicação entre a bolsa gutural afetada e a bolsa gutural normal, criando-se uma fenestração no septo-medial entre elas. Pretendeu-se, com este trabalho, observar-se o tempo dispendido desde a incisão para produzir a fenestração, até sua completa cicatrização incluindo fenômenos cicatriciais pós-operatórios como a evolução das reações locais, a formação de tecido de granulação, a ocorrência de neovascularização, o grau de cicatrização de acordo com o tempo transcorrido, assim como a verificação de formação ou não de estoma intergutural.

Evaluation of the healing process in medial septum fenestration of the guttural pouch in the horse / Avaliação dos processos de cicatrização da fenestração do septo-medial da bolsa gutural em eqüinos

The guttural pouch tympany is characterized by a painless distension of the parotid region, frequently severe enough to displace the pharynx and trachea and to compress the contralateral guttural pouch. In timpanites of the guttural pouches, surgical access is achieved through Viborg"s triangle, an attempt to establish a communication between the affected and the normal guttural pouches through a fenestration in the medium wall between them. The objective of this study was to observe the time necessary from the incision to produce the fenestration until the complete healing, as well as the post-surgical scarring phenomena such as evolution of local reactions, formation of granulation tissue, neovascularization, scarring degree along time, and to observe the formation or not of interguttural stoma.

O timpanismo de bolsa gutural caracteriza-se por uma distensão indolor da região parotídea, frequentemente severa o bastante para deslocar a faringe e a traquéia, e comprimir a bolsa gutural contralateral. A bolsa gutural pode ser acessada cirurgicamente, em casos de timpanismo, através do triângulo de Viborg. Essa cirurgia consiste em se estabelecer uma comunicação entre a bolsa gutural afetada e a bolsa gutural normal, criando-se uma fenestração no septo-medial entre elas. Pretendeu-se, com este trabalho, observar-se o tempo dispendido desde a incisão para produzir a fenestração, até sua completa cicatrização incluindo fenômenos cicatriciais pós-operatórios como a evolução das reações locais, a formação de tecido de granulação, a ocorrência de neovascularização, o grau de cicatrização de acordo com o tempo transcorrido, assim como a verificação de formação ou não de estoma intergutural.

Glossopharyngeal and vagus neuropathy associated to stylopharyngeus muscle compression in horse guttural pouch case report / Neuropatia do glossofaringeo e vago associada à compressão pelo musculo estilofaringeo em bolsa gutural de equino relato de caso

Neuropathies of pharyngeal branches of glossopharyngeal and vagus are often associated with guttural pouches diseases; however, these branches of injury due to stylopharyngeus muscle compression are not reported. A case was reported of a quarter horse mare, 8 years old, 450 kg, presenting dyspnea and respiratory noise associated with weight loss. Clinical examination observed mixed dyspnea, tachycardia, dysphagia, sialorrhea, lung crackles and submandibular and parotid lymphadenopathy. Endoscopic exam showed right arytenoid chondritis, nasopharyngeal collapse, generalized larynx edema and dorsal displacement of the soft palate. Right guttural pouch evaluation showed swelling in the origin of stylopharyngeus muscle with consequent compression of the XII, X and IX cranial nerves. Tracheotomy, systemic treatment with corticosteroids, beta lactams and aminoglycosides antibiotics were performed. No resolution was observed and, after 16 days, the animal showed clinical worsening, developed pleuropneumonia, uveitis, severe sepsis, acute renal failure and was euthanized. The mixed neuropathy resulted in rapid clinical deterioration of the animal, due to the difficulty in swallowing and consequent associated respiratory processes. This report emphasizes the importance of evaluating stylopharyngeus muscle origin in cases of nasopharyngeal collapse associated with dysphagia in horses, giv

As neuropatias do glossofaríngeo e vago são frequentemente associadas com enfermidade das bolsas guturais. A ocorrência desta lesão secundária a compressão pelo músculo estilofaríngeo não é reportada. Relata-se o caso de uma égua quarto de milha, 8 anos de idade, 450 kg, apresentando dispneia, ruído respiratório e perda de peso. No exame clínico observou-se dispnéia mista, taquicardia, disfagia, sialorréia, crepitação pulmonar e linfadenopatia submandibular e parotídea. Ao exame endoscópico identificou-se condrite aritenóide direita, colapso nasofaríngeo, edema generalizado da laringe e deslocamento dorsal do palato mole. Na avaliação da bolsa gutural direita identificou-se aumento de volume na origem do músculo estilofaríngeo com consequente compressão dos nervos cranianos XII, X e IX. Foi realizada traqueotomia, tratamento sistêmico com corticosteróides e antibióticos. Nenhuma resolução foi observada, após 16 dias o animal apresentou piora clínica, pleuropneumonia, uveíte, sepse grave, insuficiência renal aguda e foi submetido à eutanásia. A neuropatia mista resultou em rápida deterioração clínica do animal, devido à dificuldade de deglutição e processos respiratórios associados. Salienta-se a importância de se avaliar a origem do músculo estilofaríngeo em casos de colapso nasofaríngeo associado a disfagia em cavalos, dada a possibilidade de que alterações estruturais nesse m