Radiographic identification of the equine ventral conchal bulla.
Authors: Finnegan C M, Townsend N B, Barnett T P, Barakzai S Z
Journal: The Veterinary record
Summary
# Editorial Summary The ventral conchal bulla (VCB)—the caudodorsal extension of the ventral conchal sinus—plays a crucial diagnostic role in equine sinusitis cases, yet its radiographic appearance in normal horses remains poorly characterised. Finnegan and colleagues examined ten cadaver skulls using plain radiography with and without wire markers delineating the VCB border to establish whether clinicians could reliably identify this structure on standard lateral, lateral oblique and dorsoventral views. Correct identification rates varied substantially by radiographic projection: lateral views achieved 70 per cent accuracy, lateral oblique views only 45 per cent, and dorsoventral views just 17 per cent, though clinician confidence correlated strongly with accuracy. The authors' clinical observations suggest the VCB becomes noticeably more apparent radiographically when affected by sinusitis compared to normal anatomy, implying that baseline familiarity with its normal appearance is essential for recognising pathological changes. For practitioners interpreting sinus radiographs, focusing on lateral projections and developing confidence in identifying subtle normal VCB anatomy will improve detection of sinusitis involving this compartment—particularly important given the prognostic implications of VCS involvement in equine sinus disease.
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Practical Takeaways
- •Use lateral radiographs as the most reliable view (70% accuracy) when attempting to identify the ventral conchal bulla in equine sinus disease cases
- •Understand normal radiographic anatomy of the VCB in healthy horses to better recognize pathological changes and identify sinusitis involving this compartment
- •If you struggle to identify the VCB on radiographs, pathology may be present; consult additional imaging or surgical exploration rather than assuming normality
Key Findings
- •The ventral conchal bulla (VCB) was correctly identified in 70% of lateral radiographs, but only 45% of lateral oblique and 17% of dorso-ventral radiographs in clinically normal horses
- •Clinician confidence in VCB identification correlated with accuracy; confident assessments were usually correct while those judged as 'difficult' were usually incorrect
- •The VCB is more radiologically evident in horses with sinusitis affecting the ventral conchal sinus compared to clinically normal horses