Necrosis of the nasal conchae in 12 horses.
Authors: Cehak A, von Borstel M, Gehlen H, Feige K, Ohnesorge B
Journal: The Veterinary record
Summary
# Editorial Summary: Nasal Conchal Necrosis in Horses Unilateral malodorous nasal discharge represents a diagnostic challenge in equine practice, and this case series documents a significant but apparently under-recognised pathology: necrosis of the nasal conchae affecting 12 horses across a range of presentations. The clinicians used a multimodal approach—clinical examination, endoscopy, radiography, and computed tomography in one case—supplemented by microbiology and histological samples from selected cases, establishing a thorough diagnostic framework for what appears to be a localised tissue death process within the nasal passages. Notably, the condition manifested as unilateral necrosis in 11 horses and bilateral in one, with no predilection for specific conchae, suggesting variable aetiology rather than anatomically determined disease. All 12 horses responded well to transendoscopic removal of affected tissue using a polypectomy snare under standing sedation, with six receiving post-operative topical disinfectant treatment, and complete healing occurred in every case without complication. For practitioners managing horses with persistent or foul-smelling nasal discharge, particularly when routine investigations appear unremarkable, endoscopic examination to visualise the conchae warrants consideration; the benign nature of the procedure and the excellent prognosis following tissue removal make it a practical intervention with minimal risk and clear therapeutic benefit.
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Practical Takeaways
- •Unilateral malodorous nasal discharge in horses should raise suspicion for conchal necrosis and warrants endoscopic examination
- •Transendoscopic debridement under standing sedation is an effective and safe treatment option with excellent prognosis when all necrotic tissue is removed
- •Local disinfectant application post-treatment may not be necessary for successful healing in all cases
Key Findings
- •Conchal necrosis presented as unilateral malodorous nasal discharge in 11 of 12 horses, with one horse affected bilaterally
- •No particular concha was preferentially affected, suggesting non-selective involvement
- •Transendoscopic removal of necrotic tissue using polypectomy snare under standing sedation resulted in complete healing without complications in all 12 cases
- •Mild disinfectants were used locally in 6 of 12 horses post-treatment, though all cases healed successfully regardless