A long-term study of 277 cases of equine sinonasal disease. Part 2: treatments and results of treatments.

Authors: Tremaine W H, Dixon P M

Journal: Equine veterinary journal

DOI: 10.2746/042516401776249787 PubMed: 11352351Log in to save

Summary

# Editorial Summary: Equine Sinonasal Disease Treatment Outcomes Tremaine and Dixon's two-decade analysis (1984–1996) of 277 horses with sinonasal pathology offers clinicians robust evidence on which treatments deliver lasting results, tracking outcomes over a median 24-month follow-up period. Medical and surgical interventions for mycosis and primary sinusitis proved highly effective, with 92% and 84% of cases respectively achieving complete remission, whilst sinus cysts and dental-related sinusitis showed good long-term control at 82% and 78%—suggesting that anatomical factors and aetiology significantly influence prognosis. Progressive ethmoidal haematoma and neoplastic lesions present considerably greater therapeutic challenges, with only 33% and 12% of horses returning to clinical normality, highlighting the importance of early differential diagnosis and owner counselling regarding realistic expectations. These data underscore that most sinonasal conditions respond favourably to appropriate intervention, but practitioners should temper optimism when diagnosing PEH or malignancy, where recurrence and progressive deterioration remain common despite treatment. The stratification of outcomes by diagnosis provides a framework for evidence-based treatment planning and client communication, though individual factors including chronicity, concurrent infection, and compliance with post-treatment management will modulate these population-level success rates.

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Practical Takeaways

•Sinonasal mycosis, primary sinusitis, and sinus cysts respond well to treatment with high remission rates, making these favourable diagnoses for prognosis discussions with owners
•Progressive ethmoidal haematoma and sinonasal neoplasia carry poor long-term prognoses (33% and 12% remission respectively), requiring careful case selection and realistic owner expectations
•Long-term follow-up (minimum 24 months) is essential for assessing true treatment success in sinonasal disease, as early apparent recovery may not reflect sustained remission

Key Findings

•92% of horses with sinonasal mycosis achieved complete remission of clinical signs with long-term treatment
•84% of horses with primary sinusitis showed complete remission, compared to only 33% with progressive ethmoidal haematoma
•Treatment success rates varied significantly by diagnosis, ranging from 12% remission (sinonasal neoplasia) to 92% (mycosis) at median 24-month follow-up
•Sinus cysts (82% remission) and dental sinusitis (78% remission) showed good long-term treatment outcomes

Conditions Studied

equine sinonasal mycosisprimary sinusitissinus cystsdental sinusitissinonasal traumaprogressive ethmoidal haematomasinonasal neoplasia

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