Surgical and obstetrical operations . and subcutem having beenincised to a sufficient extent, force a passage with the fingeror with probe pointed scissors closed or other blunt instru-ment through the loose connective tissue on the median sideof the parotid gland, to the guttural pouch and penetrate itat its lowest point with the finger or trocar. In order toopen the empty guttural pouch it is desirable to grasp aportion of its wall by means of forceps. Through theoperative wound a drainage tube can be introduced into thepouch, and fixed in its position by sutures. The opening XI. Open
Surgical and obstetrical operations . and subcutem having beenincised to a sufficient extent, force a passage with the fingeror with probe pointed scissors closed or other blunt instru-ment through the loose connective tissue on the median sideof the parotid gland, to the guttural pouch and penetrate itat its lowest point with the finger or trocar. In order toopen the empty guttural pouch it is desirable to grasp aportion of its wall by means of forceps. Through theoperative wound a drainage tube can be introduced into thepouch, and fixed in its position by sutures. The opening XI. Opening of the Gutturai. Pouches (Hyo- yertebrotomy) According to Viborg AND Chabert. Head and neck of recumbent horse viewedfrom the side. 5w, Stylo maxillaris muscle ;/>,parotid gland ; /, guttural pouch ; k, larynx ;st, sterno-maxillaris muscle ; r, rectus capitusanticus major muscle ; c. external carotid artery ;e, external maxillary artery ; z, internal maxil-lary artery ; z/, external maxillary vein ; 5,probe ; a, wing of OPENING OF THE GUTTURAL POUCHES. 6i can be enlarged in an anter-posterior direction to the extentof 5 to 8 cm. or large enough to admit the operators hand. A far more common operation in veterinary practicethan the opening of the guttural pouches, is the opening ofabscesses of the sub-parotid lymph glands, lying between theinner face of the parotid and the external face of the gutturalpouch. The operation here used is the same as Viborgsfor the guttural pouch but does not penetrate that cavitybecause the inner wall of the abscess has pushed the ex-ternal wall of the pouch inward so that the former largelyoccupies the usual location of the latter. The d3^spnoeagenerally prohibits casting the animal and necessitatesoperating in the standing position. In some cases thedyspnoea is so severe as to demand tracheotomy before theopening of the abscess can be undertaken because the ex-citement aggravates the difficult respiration to the point ofsuffocation
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