Guttural Pouch Examination

Inspection/Imaging of the Pouches

1. Visual observation and palpation.

2. Radiography.

3. Endoscopy - performed by passing an endoscope tube through the ventral nasal meatus and into the pharyngeal opening of the eustachian tube, and thus into the guttural pouches. Draining can be performed by passing a catheter along the same route.

4. Ulstrasonography.

5. Open surgery - best under general anaesthetic - three routes of access:

- Viborg's Triangle: incision between tendon of the sternocephalicus muscle, linguofacial vein and ramus of mandible. (Distance between triangle and pouch is greatly reduced when pouch is enlarged).

- Hyovertebrotomy: incision ventral to wing of atlas.

- Modified Whitehouse Approach: skin incision ventral to linguofacial vein, then blunt dissection along larynx to guttural pouch.