Equine paranasal sinus disease: a long-term study of 200 cases (1997-2009): ancillary diagnostic findings and involvement of the various sinus compartments.
Authors: Dixon P M, Parkin T D, Collins N, Hawkes C, Townsend N, Tremaine W H, Fisher G, Ealey R, Barakzai S Z
Journal: Equine veterinary journal
Summary
# Editorial Summary Dixon and colleagues' comprehensive 13-year retrospective analysis of 200 equine sinus disease cases provides much-needed objective evidence on the diagnostic yield of ancillary techniques and the compartmental distribution patterns in this common condition. Their cohort spanned eight distinct aetiologies—from primary sinusitis (subacute and chronic presentations) through dental, traumatic, cystic and neoplastic cases to mycotic infections and progressive ethmoid haematoma—allowing meaningful comparison of diagnostic utility across disease types. Nasal endoscopy proved highly sensitive for detecting pathology (88% showed exudate draining from sino-nasal ostia), whilst sinoscopy delivered significant diagnostic advantage and was performed in 79% of cases, with ventral conchal bulla fenestration increasingly employed to visualise rostral compartments. Radiographic fluid lines were particularly prevalent in subacute primary sinusitis (69%), though dental apical changes lacked diagnostic specificity—appearing in 29% of chronic primary cases despite absence of dental disease—a finding that emphasises the complementary value of scintigraphy (used in 20% of cases) for clarification when radiographic interpretation proved equivocal. Practitioners should recognise that caudal and rostral maxillary sinuses dominate involvement (78% and 61% respectively), whilst the ventral conchal sinus's propensity for inspissated pus accumulation (46% of affected cases) warrants particular attention during therapeutic planning and fenestration decisions.
Read the full abstract on PubMed
Practical Takeaways
- •Nasal endoscopy, sinoscopy, and skull radiography should be standard diagnostic tools for sinus disease; sinoscopy was particularly valuable for identifying compartments involved
- •Do not assume dental pathology on radiographs indicates dental sinusitis—dental changes appear in non-dental cases; use multiple diagnostic modalities for accurate diagnosis
- •Ventral conchal sinus disease is common (54% involvement) and prone to inspissated material accumulation, so thorough assessment and potentially fenestration for visualization may be needed
Key Findings
- •Nasal endoscopy demonstrated exudate drainage in 88% of cases and sino-nasal fistula in 15% of cases
- •Caudal maxillary sinuses (78% involvement) and rostral maxillary sinuses (61% involvement) were most commonly affected
- •Intra-sinus fluid lines were present in 69% of subacute primary sinusitis cases on radiography
- •Ventral conchal sinus showed greatest tendency for inspissated pus formation (46% of affected cases)
- •Radiographic dental apical changes were not specific to dental sinusitis, appearing in 29% of chronic primary sinusitis cases