Lymphonodi retropharyngeales
The retropharyngeal lymph nodes include lateral and medial groups. The medial retropharyngeal lymph nodes are the largest and most clinically significant lymph nodes in the equine head; they can be up to 5-7 cm in length. They are located in the retropharyngeal space dorsal to the pharynx and adjacent to the guttural pouch. They receive afferent drainage from nearly all other lymph nodes of the head. Their proximity to the guttural pouch means that abscessation (particularly during strangles) can rupture into this unique equine structure, causing empyema and potentially damaging the cranial nerves and internal carotid artery that traverse its walls.
Abscessation of the retropharyngeal lymph nodes is a hallmark of strangles (Streptococcus equi). Rupture into the guttural pouch can cause empyema, cranial nerve dysfunction, or hemorrhage. Enlargement can also compress the pharynx and cause respiratory obstruction. Diagnosis uses endoscopy, ultrasound, and culture.
## Overview Guttural pouch empyema is accumulation of pus in one or both guttural pouches, usually after upper-respiratory infection with Streptococcus species (including Streptococcus equi). Signs i
## Overview Neoplasia of the retropharyngeal lymph nodes, most often lymphosarcoma, creates a space-occupying mass that compresses the pharynx. Signs include progressive difficulty swallowing, respir
Fever, nasal discharge, and swelling or difficulty breathing in the upper neck or throatlatch region should be evaluated immediately, especially if strangles is suspected. Isolate the horse until cleared.
## Overview Guttural pouch empyema is accumulation of pus in one or both guttural pouches, usually after upper-respiratory infection with Streptococcus species (including Streptococcus equi). Signs include purulent nasal discharge (worse when the head is lowered), parotid swelling, and fever. Chronic cases form chondroids. ## Causes Bacterial infection, most often following strangles or other upper-airway disease. ## Diagnosis Endoscopy of the guttural pouches showing purulent material, radiographs demonstrating a fluid line, and culture. ## Treatment Repeated lavage of the pouch plus systemic and local antibiotics. Chondroids may need surgical removal. Systemic antibiotics alone rarely clear the infection. ## Recovery and Prognosis Good with thorough lavage. Nerve damage or chronic chondroids complicate some cases. ## Prevention Prompt treatment of upper-respiratory infections and strangles biosecurity. Signs include: purulent nasal discharge (worse with head down); parotid swelling; fever; material visible on endoscopy; possible Horner's syndrome
## Overview Neoplasia of the retropharyngeal lymph nodes, most often lymphosarcoma, creates a space-occupying mass that compresses the pharynx. Signs include progressive difficulty swallowing, respiratory noise, weight loss, and external swelling in the parotid region. Endoscopy shows dorsal pharyngeal compression. ## Causes Lymphoma or other neoplasia. ## Diagnosis Endoscopy, ultrasound, and biopsy or cytology of the mass. ## Treatment Palliative corticosteroids or chemotherapy. Surgical removal is rarely feasible. Prognosis is poor. ## Recovery and Prognosis Poor. Survival is typically short. ## Prevention None. Signs include: progressive dysphagia; respiratory stridor; weight loss; dorsal pharyngeal compression on endoscopy; parotid-region swelling
Abscessation of the retropharyngeal lymph nodes is a hallmark of strangles (Streptococcus equi). Rupture into the guttural pouch can cause empyema, cranial nerve dysfunction, or hemorrhage. Enlargement can also compress the pharynx and cause respiratory obstruction. Diagnosis uses endoscopy, ultrasound, and culture.
Fever, nasal discharge, and swelling or difficulty breathing in the upper neck or throatlatch region should be evaluated immediately, especially if strangles is suspected. Isolate the horse until cleared.
See the Retropharyngeal Lymph Nodes on our interactive 3D horse model. Open 3D Model