Abstract
Background: Computed tomographic (CT) imaging has shown some horses with sinonasal diseases to have changes in their sinus bony structures. Scintigraphic and clinical evidence of sinus osteitis have also been reported. However, no study has objectively examined for the presence and degree of osteitis in equine sinonasal disease.Objectives: To assess for the presence and extent of osteitis of sinus-related bony structures by examination of CT images of horses with clinically and sinoscopically confirmed unilateral sinonasal disease.Study Design: Retrospective examination of CT images of horses with confirmed, mainly chronic (>2 month duration) unilateral sinus disease of different etiologies.Methods: Bone thickness at designated sites of the maxillary bone (n = 3), frontal bone (n = 1), infraorbital canal (n = 2), and bony nasolacrimal duct (n = 1) were measured, as were the maximal diameters of the infraorbital canal and the bony nasolacrimal duct on both affected and control sides. Maxillary bone density (in Hounsfield Units) was also assessed bilaterally. Bone thickness was compared between affected and controlled sides using paired statistical tests.Results: Bone was significantly thicker in the affected sinuses compared to the control sides at the three maxillary bone sites (all, P < 0.001) and at both infraorbital bone sites (both, P < 0.001), but not at the two most dorsal sites examined, i.e. frontal bone (P = 0.188) and bony nasolacrimal duct (P = −0.260) sites. Infraorbital canal and bony nasolacrimal duct diameters were significantly wider in the affected as compared to the control sides (P < 0.001 and P = 0.002, respectively). Maxillary bone density did not differ significantly between the affected (mean = 1,075 HU, SD = 230.01) and control (mean = 1,100, SD = 200.71) sides (t(58) = −1.03, P = 0.306).Main Limitations: Possible variation in selecting measurement sites. Variation in the severity and chronicity of sinonasal disease between horses.Conclusions: Osteitis and enlargement of paranasal bony structures commonly occurs in horses with sinonasal disease and can explain the clinical presence of ipsilateral diffuse soft tissue facial swelling, epiphora, and scintigraphic evidence of bone inflammation in sinonasal disease.
Highlights
Equine sinonasal disorders are often chronic (>2 months duration), usually unilateral disorders, with multiple etiologies that are non-responsive to conservative therapy [1,2,3,4]
The computed tomography (CT) images used in this study were obtained from cases of: dental sinusitis (n = 45), subacute primary sinusitis (n = 3), chronic (>2 months) primary sinusitis (n = 8), small intrasinus cysts (n = 2), mycotic sinusitis (n = 1), and oromaxillary fistula (n = 1)
Canal diameters were significantly wider in affected than control sides for: IOC external diameter (IOCD) (P < 0.001) and NLDD (P = 0.002; Table 1, Figure 10)
Summary
Equine sinonasal disorders are often chronic (>2 months duration), usually unilateral disorders, with multiple etiologies that are non-responsive to conservative therapy [1,2,3,4]. Imaging is used to identify which sinus compartments are affected and to identify intercurrent nasal disorders, including the presence of sino-nasal fistula, inspissated exudate, bone sequestrae, and infected nasal conchal bullae and these disorders could be more correctly termed sinonasal disorders [3, 4, 9, 12,13,14]. An important early equine CT study, largely examining dental and alveolar changes in 18 cases of sinus disease by Henninger et al [9], noted maxillary bone thickening and infraorbital canal distortion in most horses. No study has objectively examined for the presence and degree of osteitis in equine sinonasal disease
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