
The guttural pouches are unique to a small number of species, including the horse. The left and right pouches are separated by the longus capitis and rectus capitis ventralis muscles. The stylohyoid bone divides the medial and lateral compartments, with the medial compartment being larger. The guttural pouches are theorized to help with brain cooling and have a capacity of approximately 475 mL in adult horses. The most common clinical presentation of guttural pouch mycosis is moderate to severe epistaxis caused by fungal erosion of the arterial structures associated with the guttural pouch.
| Characteristics | Values |
|---|---|
| Location | Behind the cranial cavity, towards the caudal end of the skull/wing of atlas |
| Enclosed by | Parotid and mandibular salivary glands, and the pterygoid muscles |
| Floor | Pharynx and beginning of the oesophagus |
| Separation | Rectus capitis ventralis and longus capitis muscles dorsomedially |
| Median septum | Formed by the fused walls of the two pouches below the muscles |
| Stylohyoid bone | Divides the medial and lateral compartments |
| Medial compartment | Approximately double the size of the lateral compartment |
| Function | Participate in the rapid cooling of arterial blood destined for the brain and surrounding structures |
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What You'll Learn
- The left and right guttural pouches are separated by the longus capitis and rectus capitis ventralis muscles
- Guttural pouches are extensions of the Eustachian tubes
- They are found in perissodactyls, like horses, tapirs, and rhinoceroses
- Guttural pouch mycosis is a fungal infection that can cause severe issues
- The pouches are paired sacs located above the pharynx

The left and right guttural pouches are separated by the longus capitis and rectus capitis ventralis muscles
The guttural pouch is a unique structure found in horses and a few other species. It is an extension of the Eustachian tube, which connects the throat to the middle ear. There are two guttural pouches, located just below the ear in the throatlatch region. These pouches are paired sacs found above the pharynx. They are also referred to as ventral diverticula of the auditory tubes.
The longus capitis and rectus capitis ventralis muscles are not the only structures that separate the left and right guttural pouches. The pterygoid muscles, the parotid and mandibular salivary glands, and the digastricus muscle also enclose the guttural pouches. The petrous part of the temporal bone, tympanic bulla, and auditory meatus are found dorsally to the pouches. The retropharyngeal lymph nodes, pharynx, and oesophagus are found ventrally.
The guttural pouches have a close association with many major structures, including several cranial nerves and arteries. The pouches directly cover the temporohyoid joint. The stylohyoid bone divides each pouch into medial and lateral compartments. The medial compartment is larger and extends more caudally and ventrally. The epithelium of the guttural pouch contains mucus-secreting goblet cells and lymph nodules.
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Guttural pouches are extensions of the Eustachian tubes
The guttural pouch is a unique structure found in horses and other odd-toed mammals, some bats, hyraxes, and the South American forest mouse. It is an air-filled outpouching or diverticulum of the Eustachian tube, with a volume of approximately 300–500 mL. The Eustachian tube, also known as the auditory tube or pharyngotympanic tube, is a structure that connects the middle ear to the pharynx, allowing for pressure equalization. The guttural pouch is formed by the escape of the mucosal lining of the Eustachian tube through a long ventral slit in the supporting cartilages.
The left and right guttural pouches are separated from each other by the longus capitis and rectus capitis ventralis muscles, as well as the median septum. These muscles are located in the space between the guttural pouch and the skull. Each pouch is moulded around the stylohyoid bone, which divides the medial and lateral compartments. The medial compartment is larger and extends more caudally and ventrally. The epithelium of the guttural pouch contains mucus-secreting goblet cells, and lymph nodules are also present.
The guttural pouch has a close association with several important structures, including cranial nerves, arteries, and the sympathetic trunk. It directly covers the temporohyoid joint, which is exposed to fractures associated with temporohyoid osteoarthropathy. The pouch may play a role in regulating intracranial blood pressure and cooling the circulation to the brain. However, its function in cooling the blood has been debated due to the potentially unattainable high rate of inspiratory airflow required.
Due to their location, guttural pouches are generally inaccessible and can be prone to infections by fungi and bacteria. These infections can be severe and challenging to treat. Guttural pouch tympany is a condition that affects several breeds of horses, including Arabian horses, and can cause severe swelling, requiring surgical correction. The plica salpingopharyngea, a mucosal fold at the caudal portion of the Eustachian tube, can sometimes act as a one-way valve, trapping air in the pouch and contributing to guttural pouch tympany.
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They are found in perissodactyls, like horses, tapirs, and rhinoceroses
The order Perissodactyla, or odd-toed ungulates, is a group of herbivorous mammals characterised by the possession of either one or three hoofed toes on each hindfoot. The name comes from the Ancient Greek "perissos" (odd) and "daktylos" (finger). Perissodactyls include horses, asses, and zebras, tapirs, and rhinoceroses.
Guttural pouches are a characteristic feature of perissodactyls. They are paired extensions of the Eustachian tubes that connect the pharynx to the middle ear. The left and right guttural pouches are separated from each other on the midline by the rectus capitis ventralis and the longus capitis muscles and the median septum. The pouches are enclosed by the parotid and mandibular salivary glands, and the pterygoid muscles. The ventral portion lies on the pharynx and beginning of the oesophagus, with the retropharyngeal lymph nodes located between the ventral wall and pharynx.
Guttural pouches are found in perissodactyls, such as equids, tapirs, rhinoceroses (except for the white rhinoceros), some bats, a South American forest mouse, and hyraxes. The pouches have a capacity of 300-500ml in the domestic horse. Due to their general inaccessibility in horses, they can be an area of infection by fungi and bacteria, and these infections can be severe and challenging to treat.
The three families of perissodactyls are: Equidae (horses, asses, and zebras), Rhinocerotidae (rhinoceroses), and Tapiridae (tapirs). The eighteen extant species are divided into two suborders: Ceratomorpha, containing the families Rhinocerotidae and Tapiridae, and Hippomorpha, containing the family Equidae.
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Guttural pouch mycosis is a fungal infection that can cause severe issues
The guttural pouch is located behind the cranial cavity, towards the caudal end of the skull, and is enclosed by the parotid and mandibular salivary glands, and the pterygoid muscles. The left and right guttural pouches are separated by the longus capitis and rectus capitis ventralis muscles dorsomedially. The median septum, formed by the fusion of the two pouches, separates the pouches on the midline. The stylohyoid bone divides the medial and lateral compartments.
Guttural pouch mycosis is a fungal infection that can affect one or both guttural pouches in horses. The infection is caused by the fungus Aspergillus, which forms fungal plaques along the walls of major blood vessels, including the internal carotid, external carotid, and maxillary arteries. Over time, the fungus can erode through the vessel walls, resulting in life-threatening haemorrhage and, if left untreated, a fatal bleed. The condition is rare but potentially fatal, and the clinical signs are variable and closely related to the structures involved.
One of the most common clinical signs is epistaxis, which can range from mild to severe and unilateral to bilateral. Other common signs include dysphagia, secondary aspiration pneumonia, pharyngeal paresis/laryngeal hemiplegia, and Horner's syndrome. Less common signs may include mucopurulent nasal discharge, corneal ulcers, head shyness, blindness, tongue paralysis, and mycotic encephalitis.
Endoscopy is the most commonly used diagnostic tool for guttural pouch mycosis, allowing for direct visualisation and evaluation of affected structures. Other diagnostic methods include radiographs and computed tomography. Treatment options include medical and surgical approaches. Medical treatment involves the infusion of topical antifungal agents into the affected area, with or without systemic antifungal medications. Surgical treatments aim to occlude or block the affected artery to prevent haemorrhage and eliminate the blood supply to the fungus.
The guttural pouch has a close association with several important structures, including cranial nerves, arteries, and the temporohyoid joint. Its functions include pressure equilibration across the tympanic membrane, brain cooling, and acting as a resonating chamber for vocalisation.
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The pouches are paired sacs located above the pharynx
The guttural pouches are paired sacs located above the pharynx. They are found in perissodactyls, such as horses, tapirs, rhinoceroses, some bats, a South American forest mouse, and hyraxes. Guttural pouches are paired extensions of the Eustachian tubes that connect the pharynx to the middle ear. They are formed by the escape of the mucosal lining of the tube through a long ventral slit in the supporting cartilage. The pouches are separated from each other on the midline by the rectus capitis ventralis and the longus capitis muscles and the median septum.
The left and right guttural pouches have almost the same capacity. The medial compartment is 2 to 3 times the size of the lateral compartment and extends more caudally and ventrally. The right and left pouches do not communicate with each other and are symmetrically separated rostrally by a thin septum and caudally by the longus capitis and rectus capitis ventralis muscles. The plica salpingopharyngea, a mucosal fold at the caudal portion of the Eustachian tube, forms an uninterrupted channel between the medial lamina of the Eustachian tube and the lateral wall of the pharynx.
The guttural pouch has a close association with many major structures, including several cranial nerves and arteries that lie directly against the pouch as they pass into and out of foramina in the caudal aspect of the skull. The pouches are enclosed by the parotid and mandibular salivary glands, and the pterygoid muscles. The ventral portion lies on the pharynx and the beginning of the oesophagus, with the retropharyngeal lymph nodes located between the ventral wall and the pharynx.
Pharyngeal pouches, on the other hand, are bulging sacs that develop during the segmental phase of pharyngeal arch development. They emerge in the fourth week of embryological development in vertebrates and are composed of ectoderm, endoderm, and a mesoderm core containing mesoderm and neural crest cells. The pharyngeal pouches form partitions between each pharyngeal arch, with the first pharyngeal pouch lying between arches one and two, and the second pharyngeal pouch sitting between the second and third arches. The third pouch is in between the third and fourth arches, and the fourth pharyngeal pouch lies between the fourth arch and the terminal, sixth arch.
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Frequently asked questions
The left and right guttural pouches are separated by the longus capitis and rectus capitis ventralis muscles.
These muscles, along with the median septum, separate the left and right guttural pouches on the midline.
The guttural pouches are located below the cranial cavity, towards the caudal end of the skull, and are enclosed by the parotid and mandibular salivary glands, as well as the pterygoid muscles.











































