A computed tomographic assessment of osteitis of sinus bony structures in horses with sinonasal disorders

Paddy Dixon, Coline Puidupin, Dewi Borkent, Tiziana Liuti, Richard Reardon

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Background: Computed tomographic (CT) imaging has shown some horses with sinonasal diseases to have changes in their sinus bony structures. Scintigraphic and clinical evidence of sinus osteitis have also been reported. However, no study has objectively examined for the presence and degree of osteitis in equine sinonasal disease.Objectives: To assess for the presence and extent of osteitis of sinus-related bony structures by examination of CT images ofhorses with clinically and sinoscopically confirmed unilateral sinonasal disease.Study design: Retrospective examination of CT images of horses with confirmed, mainly chronic (>2 month duration) unilateralsinus disease of different aetiologies.Methods: Bone thickness at designated sites of the maxillary bone (n=3), frontal bone (n=1), infraorbital canal (n=2) and bonynasolacrimal duct (n=1) were measured, as were the maximal diameters of the infraorbital canal and the bony nasolacrimal ducton both affected and control sides. Maxillary bone density (in Hounsfield Units) was also assessed bilaterally. Bone thickness was compared between affected and controlled sides using paired statistical tests.Results: Bone was significantly thicker in the affected sinuses compared to the control sides at the three maxillary bone sites (all, P<0.001) and at both infraorbital bone sites (both, P<0.001), but not at the two most dorsal sites examined, i.e. frontal bone(P=0.188) and bony nasolacrimal duct (P=-0.260) sites. Infraorbital canal and bony nasolacrimal duct diameters were significantlywider in the affected as compared to the control sides (P<0.001 and P=0.002 respectively). Maxillary bone density did not differsignificantly between the affected (mean=1075 HU, SD=230.01) and control (mean 1100, SD=200.71) sides (t(58)=-1.03, P=0.306).Main Limitations: Possible variation in selecting measurement sites. Variation in the severity and chronicity of sinonasal diseasebetween horses.Conclusions: Osteitis and enlargement of paranasal bony structures commonly occurs in horses with sinonasal disease and can explain the clinical presence of ipsilateral diffuse soft tissue facial swelling, epiphora and scintigraphic evidence of boneinflammation in sinonasal disease. Osteitis or distortion of the infraorbital canal or maxillary septal bulla may cause difficulty insinoscopically fenestrating the maxillary septal bulla in horses with sinonasal disease.
Original languageEnglish
JournalFrontiers in Veterinary Science
Early online date11 Sep 2020
Publication statusE-pub ahead of print - 11 Sep 2020


  • equine sinonasal disease
  • equine sinusitis
  • equine sinus osteitis
  • horse
  • equine sinonasal imaging
  • equine sinonsal disease
  • equine sinusitis related osteitis


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