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

Summary

Guttural pouch mycosis presents a significant clinical challenge due to the risk of life-threatening epistaxis, dysphagia and secondary complications, yet conventional endoscopic treatments can be costly and require prolonged management. Watkins and Parente reviewed seven horses treated with salpingopharyngostomy (creating a direct fistula from the guttural pouch into the pharynx) between 2006 and 2017, hypothesising that this approach would alter the pouch environment sufficiently to promote fungal plaque regression without additional interventions. All horses showed resolution of nasal discharge within 10–30 days post-operatively, with complete mycotic plaque clearance occurring between one and six months; notably, no animal developed epistaxis or new neurological deficits attributable to the procedure. The technique offers practical advantages including reduced treatment costs, outpatient feasibility and superior exposure of infected tissue, though it is contraindicated in horses with active or recent epistaxis. This case series demonstrates that salpingopharyngostomy can be an effective, uncomplicated alternative to conventional management in appropriately selected cases, potentially streamlining both acute and convalescent care for affected horses.

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Key Findings

• •Nasal discharge resolved in 10-30 days post-operatively in all cases where present
• •Mycotic plaques showed complete resolution at 1-6 months post-operatively
• •No cases developed epistaxis or neurological deficits post-operatively that were not present at presentation
• •Salpingopharyngostomy can be performed on an outpatient basis with few complications

Conditions Studied

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