54 OPENING OF THE GUTTURAL POUCHES 



by sutures. The opening can be enlarged in an antero- 

 posterior direction to the extent of 5 to 8 cm. or large 

 enough to admit the operator's hand. Through this 

 enlarged wound, the operator may palpate the Eustachian 

 tube and other portions of the interior of the pouch and 

 perform desired operations. 



A far more common operation in veterinary practice than 

 the opening of the guttural pouches, is the opening of 

 strangles abscesses of the sub-parotid lymph glands, lying 

 between the inner face of the parotid gland and the external 

 face of the guttural pouch. The operation here used is the 

 same as Viborg's for the guttural pouch but does not pene- 

 trate that cavity because the inner wall of the abscess has 

 pushed the external wall of the pouch inward so that the 

 former largely occupies the usual location of the latter. 

 The dyspnoea generally prohibits casting the animal and 

 necessitates operating in the standing position. In some 

 cases the dyspnoea is so severe as to demand tracheotomy 

 before the opening of the abscess can be undertaken because 

 the excitement aggravates the difficult respiration to the 

 point of suffocation. 



II. Chabert's method. Secure the horse in the lateral re- 

 cumbent position, remove the hair and disinfect the skin 

 beneath the wing of the atlas. Make an incision about i 

 cm. in front of the lower half of the wing of the atlas 

 and parallel to it, about 6 cm. long, extending through the 

 skin and skin muscle down to the parotid gland. The In- 

 cision is facilitated by rendering the skin tense with the, left 

 hand and care is to be taken not to wound the auricular 

 nerve which passes directly along the atlas. Draw back- 

 ward the posterior lip of the wound and separate with blunt 

 instruments the posterior border of the parotid gland from 

 the atlas, to which it is bound by loose connective tissue. 

 Then draw the parotid gland forward with tenacula. At 

 the bottom of the opening thus formed there is seen the 



