Equine Sinuses

Question 1

signs of empyema of nasal conchal bulla

Answer 1

usually mucopurulent unilateral malodorous nasal discharge

Question 2

surgical approaches to the sinuses

Answer 2

sinusotomy:

• trephination
• bone flaps (maxillary vs. frontonasal bone flaps)

sinoscopy

Question 3

causes of secondary sinusitis

Answer 3

dental disease***, cyst, neoplasia

Question 4

what divides the dorsal nasal diverticulum from the ventral meatus?

Answer 4

alar fold

Question 5

how does the ventral choncal sinus drain?

Answer 5

via the conchomaxillary opening into the rostral maxillary sinus

the rostral maxillary sinus drains into the nasomaxillary opening

Question 6

most common isolate of sinusitis in horses

Answer 6

strep

Question 7

preferred type of bone flap

Answer 7

frontonasal bone flap

Question 8

most common tumor of the paranasal sinuses

Answer 8

SCC

Question 9

signalment for progressive ethmoid hematoma

Answer 9

any age but usually >10 yo

males>females

Question 10

do the rostral and caudal maxillary sinuses communicate?

Answer 10

no

Question 11

how does the middle conchal sinus drain?

Answer 11

both the middle conchal sinus and the sphenopalatine sinus drain over the infraorbital canal into the caudal maxillary sinus

Question 12

signalment or paranasal sinus cyst

Answer 12

more common in young but can be any age

Question 13

which sinuses make up the conchofrontal sinus?

Answer 13

frontal sinus and dorsal conchal sinus

Question 14

diagnosis of paranasal sinus neoplasia

Answer 14

histo

on CT you’ll see a solid well defined mass with bony destrcution

Question 15

treatment for empyema of the nasal conchal bulla

Answer 15

FENESTRATE conchal bulla or enlarge draining orifice if already present using nd: YAG laser or long handled instruments

Question 16

how do the rostral and caudal maxillary sinuses drain?

Answer 16

into the nasomaxillary opening (into the middle meatus) via the sinonasal channel

Question 17

appearance of paranasal sinus neoplasia on CT

Answer 17

solid well defined mass with bony destruction

Question 18

what divides the nasal conchae?

Answer 18

the nasal conchae are divided into conchae bulla and conchae sinuses by the nasal septum

Question 19

empyema means…

Answer 19

inspissated pus in a natural diverticulum/blind cavity structure in the body

Question 20

most common expansile mass in sinsues of horses

Answer 20

paranasal sinus cyst

Question 21

the middle concal sinus is also called…

Answer 21

ethmoidal sinus

Question 22

which teeth protrude into the rostral maxillary sinus?

Answer 22

PM4 and M1

Question 23

treatment for paranasal sinus cyst

Answer 23

surgical excision required because does NOT spontaneously regress

sinusotomy: MUST remove cyst lining

Question 24

pathogenesis of ethmoid hematoma

Answer 24

idiopathic hemorrhage in submucosa of endoturbinates-> hematoma with fibrous capsule

Question 25

signs of paranasal sinus neoplasia

Answer 25

• halitosis
• nasal discharge (mucopurulent, serosanginous)
• fascial swelling
• LN enlargement in 80% of cases

Question 26

what divides the maxillary sinus into medial and lateral compartments?

Answer 26

infraorbital canal

Question 27

what divides the nasal passage into dorsal, ventral, and middle meatuses?

Answer 27

dorsal and ventral nasal conchae

Question 28

signs of progressive ethmoid hematoma

Answer 28

usually unilateral

mild intermittent epistaxis that may increase with exercise
+/- abnormal sounds if extends into nasal cavity, malodorous breath from pressure necrosis, obstructed airflow, fascial swelling if extends into sinus

Question 29

how does the conchofrontal sinus drain?

Answer 29

into the caudal maxillary sinus via the frontomaxillary aperature

Question 30

treatment for progressive ethmoid hematoma

Answer 30

• 10% formalin injection

- sinusotomy via bone flap or trephination for large masses extending into sinuses

Question 31

recurrence rate for ethmoid hematomas

Answer 31

40% -> do endoscopic recheck every 6 months

Question 32

signs of empyema of the nasal conchal bulla

Answer 32

inspissated pus -> mucopurulent unilateral malodorous nasal discharge