Computed Tomographic Assessment of Individual Paranasal Sinus Compartment and Nasal Conchal Bulla Involvement in 300 Cases of Equine Sinonasal Disease.
Authors: Dixon Padraic M, Barnett Tim P, Morgan Rhiannon E, Reardon Richard J M
Journal: Frontiers in veterinary science
Summary
# Editorial Summary This retrospective CT study of 300 horses with confirmed unilateral sinonasal disease maps the anatomical distribution of sinus involvement and identifies associated nasal conchal bulla (NCB) pathology that clinicians often encounter alongside primary sinus conditions. The rostral maxillary and ventral conchal sinuses were overwhelmingly affected (94.7% and 87% respectively), whilst caudal compartments including the frontal, ethmoidal and sphenopalatine sinuses showed significantly lower involvement rates (26–32.7%). Perhaps more clinically striking is that 56% of horses with sinus disease presented concurrent NCB infection or destruction—predominantly the ventral bullae (42.3%)—highlighting the interconnected pathology of these structures and validating the adoption of "sinonasal disease" as an appropriate diagnostic term. The finding that gravity-dependent compartments bear disproportionate disease burden carries implications for treatment planning, surgical access and prognosis, whilst the high prevalence of NCB involvement suggests that comprehensive imaging assessment of both sinuses and bullae should be standard practice rather than incidental observation. Whilst the study cohort may skew towards more complex or high-value cases, these results establish expected patterns of involvement that equine practitioners can use to interpret CT findings and anticipate concurrent pathology in their diagnostic and therapeutic decision-making.
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Practical Takeaways
- •When treating equine sinus disease, prioritize imaging and assessment of the rostral maxillary and ventral conchal sinuses as these are affected in >85% of clinical cases
- •Expect concurrent nasal conchal bulla involvement in more than half of sinus disease cases and include these structures in your clinical examination and treatment planning
- •Consider the term 'sinonasal disease' rather than isolated sinusitis, as this better reflects the frequent multi-compartment involvement seen clinically
Key Findings
- •Rostral maxillary sinus was involved in 94.7% of sinus disease cases, making it the most commonly affected compartment
- •Ventral conchal sinus was affected in 87% of cases, demonstrating the importance of assessing dependent sinus compartments
- •Nasal conchal bulla involvement occurred in 56% of horses with sinus disorders, with ventral bullae affected in 42.3% of cases
- •Caudal sinuses (caudal maxillary, frontal, ethmoidal, sphenopalatine) were less commonly affected, ranging from 26-65.3%