Swellings of the angle of the mandible in 32 horses (1997-2011).
Authors: Dixon P M, Loh N, Barakzai S Z
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary: Mandibular Angle Swellings in Horses Swellings of the mandibular angle present a diagnostic challenge in equine practice, yet remain poorly characterised in the literature despite being a recognised presentation at tertiary referral centres. Dixon and colleagues reviewed 32 cases seen at Edinburgh University Equine Hospital over 15 years, identifying aetiologies through clinical examination, imaging, and surgical exploration where indicated. A definitive diagnosis was established in only 41% of cases (fractures, neoplasia, salivary gland inflammation, and traumatic soft tissue or bone lesions), whilst the remaining 59% fell into two patterns: localised periosteal or cortical lesions of the ventral mandibular angle (likely traumatic) and chronic soft tissue infections with sinus tracts on the medial aspect, frequently secondary to retropharyngeal disease draining through the angle region. Surgical intervention—combining soft tissue excision with bone curettage—proved most effective, particularly for cases with purulent tracts or underlying retropharyngeal pathology that failed medical management. This work underscores that whilst trauma accounts for most mandibular angle swellings, the substantial proportion (22%) associated with draining retropharyngeal lesions warrant thorough intraoral and endoscopic assessment, as these cases typically respond poorly to antibiotics alone but respond favourably to definitive surgical treatment.
Read the full abstract on PubMed
Practical Takeaways
- •Mandibular angle swellings in horses are often of obscure origin; always investigate for retropharyngeal pathology as these cases typically need surgical drainage rather than medical management alone
- •Many cases appear traumatic and do not progress to gross fracture due to protective musculature, so conservative management with monitoring may be appropriate for some presentations
- •When medical therapy fails for persistent mandibular angle swelling, particularly with sinus tracts, surgical exploration and curettage should be considered as the most reliable treatment option
Key Findings
- •Of 32 horses with mandibular angle swellings, definitive diagnosis was achieved in only 13 cases (41%), with fractures, traumatic lesions, neoplasia, and glandular/muscular inflammation identified
- •Twelve undiagnosed cases displayed localised periosteal/cortical lesions on the ventral angle of the mandible, likely traumatic in origin
- •Seven undiagnosed cases had sinus tracts and chronic soft tissue infections on the medial angle, with five attributed to draining retropharyngeal lesions
- •Surgical excision of abnormal tissues combined with bone curettage proved most successful; retropharyngeal lesion cases responded poorly to medical therapy but well to surgical intervention