A long-term study of 277 cases of equine sinonasal disease. Part 1: details of horses, historical, clinical and ancillary diagnostic findings.
Authors: Tremaine W H, Dixon P M
Journal: Equine veterinary journal
Summary
# Editorial Summary: Equine Sinonasal Disease — A Comprehensive 12-Year Case Series Over a 12-year period, Tremaine and Dixon retrospectively analysed 277 equine cases of sinonasal disease referred to a specialist centre, documenting a remarkably diverse range of pathologies where primary sinusitis (24.2%) and dental-related sinusitis (22.0%) accounted for nearly half of all presentations, whilst rarer conditions such as mycosis (4.7%) and polyps (2.5%) featured alongside more aggressive pathologies like neoplasia (7.9%) and progressive ethmoid haematoma (7.6%). Whilst nasal discharge appeared in 88% of cases and facial swelling in 46%, these non-specific signs proved clinically unreliable for differential diagnosis; the chronic nature of most presentations (median 12 weeks, ranging from days to 6 years) underscores the diagnostic challenge these conditions pose. Endoscopic examination, though abnormal in 91% of cases, contributed definitive diagnosis in only 20%, whilst radiography was similarly limited at 36% diagnostic utility—a finding that highlights the critical diagnostic role of sinoscopy, which achieved 70% diagnostic success in the 61 cases where it was employed. For practitioners managing horses with persistent sinonasal signs, this work emphasises the need for structured diagnostic protocols beyond clinical examination alone, particularly where dental pathology, neoplasia or cysts are suspected, given the substantial treatment implications and prognosis variations between these distinct entities.
Read the full abstract on PubMed
Practical Takeaways
- •Nasal discharge and facial swelling are non-specific findings in sinonasal disease; endoscopy alone is insufficient for diagnosis—sinoscopy should be considered when available for improved diagnostic accuracy
- •Dental disease is responsible for nearly one-quarter of sinonasal cases, highlighting the importance of thorough oral examination in horses presenting with nasal signs
- •Most sinonasal conditions are chronic at presentation (median 12 weeks), suggesting early recognition and referral could improve outcomes before secondary changes occur
Key Findings
- •Primary sinusitis (24.2%) and dental sinusitis (22.0%) were the most common diagnoses among 277 equine sinonasal disease cases
- •Nasal discharge was present in 88% of cases and facial swelling in 46%, with median duration of signs 12 weeks prior to referral
- •Endoscopy detected changes in 91% of cases but contributed to exact diagnosis in only 20%, while sinoscopy was diagnostically useful in 70% of cases where used
- •Sinus cysts and sinonasal neoplasia showed significantly greater association with gross distortion of nasal passages and facial bones compared to other sinonasal disorders