Equine sinonasal disease

Question 1

Primary Paranasal Sinusitis in horses is most often caused by?

Answer 1

Following transient URT infection (usually strep infection)
fungal infection (less common)

Question 2

Secondary Paranasal Sinusitis in horses is most often caused by?

Answer 2

Infection of a tooth root (dental sinusitis)
Trauma to facial bone
Expanding mass (e.g., neoplasm or sinus cyst)
Inspissated exudate

Question 3

T/F Young horses most commonly develop secondary sinusitis

Answer 3

False! most commonly develop primary sinusitis. Most susceptible to Strep equi var equi

Question 4

T/F Old horses are more likely to develop secondary sinusitis

Answer 4

True!

Question 5

T/F Horses which do not respond to sinus lavage and treatment with broad spectrum antimicrobials probably have primary sinusitis

Answer 5

False! probably do not have primary sinusitis

Question 6

Clinical signs of Paranasal Sinusitis

Answer 6

Persistent, purulent,unilateral, nasal discharge
Epiphora, conjunctivitis
Enlarged submandibular LNs
Obstructed airflow
Facial distortion
Distortion of nasal passage/respiratory stertor
Halitosis
Head-tilt
Decreased resonance during percussion

Question 7

How does Bilateral Discharge from nares differ from unilateral discharge

Answer 7

Bilateral if: Guttural pouches, Nasopharynx, Lungs, Both paranasal sinuses
Unilateral if:Unilateral sinusitis, Nasal cavity

Question 8

Diagnosis of paranasal sinusitis

Answer 8

Radiology and now CT
Percussion
Oral examination
Endoscopy/sinoscopy

Question 9

Why do I need to break down the bulla?

Answer 9

Inspissated exudate will not flush out as protected by a bulla (Secondary Sinusitis)

Question 10

General treatment of primary and secondary sinusitis

Answer 10

Lavage of sinuses
Broad-spectrum antimicrobial therapy
Removal of cause if secondary

Question 11

Treatment of Primary Fungal Sinusitis

Answer 11

Irrigate sinuses with enilconazole
Canestan cream works well

Question 12

Treatment of Secondary Sinusitis - Cystic sinus disease

Answer 12

Removal of cyst through frontonasal or maxillary sinusotomy or trephine hole

Question 13

What is Atheroma

Answer 13

Cyst in nasal diverticulum
Aberrant epithelial tissue

Question 14

Treatment of atheroma

Answer 14

Can be removed with a burr

Question 15

What is Wry Nose

Answer 15

Congenital deviation & shortening of premaxillae, nasal bones, & septum

Question 16

Treatment of Wry nose

Answer 16

Foal may survive with good nursing
Euthanasia may be tx of choice
Surgical correction possible

Question 17

Horse presents with Serosanguineous, odorous nasal discharge. It has airway obstruction and facial distortion. What is most likely dx?

Answer 17

Nasal Neoplasia