Empyema of the nasal conchal bulla as a cause of chronic unilateral nasal discharge in the horse: 10 cases (2013-2014)

REASONS FOR PERFORMING STUDY: Empyema of the nasal conchal bullae has recently been identified in horses suffering from chronic unilateral nasal discharge. The diagnosis and management of such cases has not been reported previously.

OBJECTIVES: To describe the diagnosis and treatment of cases suffering from empyema of the nasal conchal bullae and report the frequency of diagnosis from a population of horses referred for head computed tomography (CT).

STUDY DESIGN: Retrospective case review.

METHODS: Records from cases diagnosed with nasal conchal bulla disease using CT were reviewed.

RESULTS: Abnormalities of the nasal conchal bullae were identified by CT in 10 cases (8 ventral conchal bulla, 8 dorsal conchal bulla), from 102 equine head CT examinations. Eight cases were subsequently treated at the study clinic, 7 of which had concurrent paranasal sinus disease. In 3 cases, fenestration of the ventral conchal bulla per nasum facilitated drainage and clearance of empyema.

CONCLUSIONS: Disease of the conchal bullae should be considered as a potential cause of chronic unilateral nasal discharge in horses. Clearance of empyema within these bullae is unlikely to occur through lavage of the paranasal sinuses alone. Where necessary, fenestration of the bulla allows physical removal of infected material.