Endoscopically assisted transcutaneous placement of a balloon catheter in the medial guttural pouch compartment of the horse: A surgical approach to local treatment.

OBJECTIVE: To describe and report clinical outcomes after transcutaneous guttural pouch (GP) catheterization (TGPC) in standing horses. STUDY DESIGN: Ex vivo study and case series. ANIMALS: One cadaver head, records of 10 normal horses and 14 horses treated with TGPC. METHODS: Relevant anatomical landmarks were determined through dissection of one cadaveric specimen and 10 normal radiographic studies. Records of horses diagnosed with empyema or mycosis and treated with standing TGPC were reviewed for complications that occurred during or after the operation. RESULTS: Ex vivo and radiological studies identified the tissues crossed by the catheter and anatomical variations of the stylohyoid. TGPC performed on one (n = 13) or both (n = 1) GPs was successful in all cases. The balloon catheter placed in the parotid region allowed administration of oxygen and lavage solution and facilitated passive or active drainage. Complications included hemorrhage from the skin (3/15; 21%), catheter balloon rupture (1/15; 7%), cutaneous salivary fistula (1/15; 7%), abrasions under the fixation ring (15/15; 100%) and catheter dislodgement (3 of 500 treatment sessions). The balloon catheter remained in place for 4 to 17 days. Following catheter removal, sealing of the GP was achieved within 72 h; second-intention healing was complete in less than 10 days. CONCLUSION: TGPC in standing horses was frequently associated with minor complications but allowed local treatment for up to 17 days. CLINICAL SIGNIFICANCE: This study provides evidence to support the transcutaneous placement of a 20 Fr balloon catheter in the GP for local treatment.