TY - JOUR

T1 - Paranasal sinus cysts in the horse: Complications related to their presence and surgical treatment in 37 cases

AU - Fenner, M. F.

AU - Verwilghen, D.

AU - Townsend, N.

AU - Simhofer, H.

AU - Schwarzer, J.

AU - Zani, D. D.

AU - Bienert-Zeit, A.

PY - 2019

Y1 - 2019

N2 - BackgroundParanasal sinus cysts (PSC) are a common cause of equine secondary sinusitis. The outcome and associated complications have not been frequently reported.ObjectivesTo review the associated clinical signs, associated morbidities and outcomes of horses treated for PSC.Study designRetrospective multicentre case series.MethodsRetrospective analysis of case records and telephone follow up survey.ResultsSubjects were 37 horses 1–24 years old that were presented with nasal discharge (n = 31), facial swelling (n = 25) and epiphora (n = 19). Radiography and computed tomography allowed identification of the cyst‐induced changes including concomitant tissue destruction (n = 31), leading among other things to local nerve damage causing headshaking (n = 6) and unilateral blindness (n = 1). Radiographic changes to adjacent dental apices were present in 10 horses. Horses over 10 years old showed more of the named associated problems. Post‐operative complications included surgical site infection (SSI) (n = 11), nasofrontal suture periostitis (n = 6) and sequestration (n = 1) following removal of the PSC via osteotomy.The long‐term response to treatment was available for 28 cases with 22 horses (78.6%) fully cured, 4 (14.3%) partially cured and 2 (7.1%) not responding to treatment. In 7 horses (18.9%) there was recurrence of the cyst post‐operatively.Main limitationsDue to the study being a multicentre retrospective case series with collection of data over an extended period, there may be inconsistency in data recording and absence of reporting of some findings.ConclusionsOverall, the diagnosis and treatment of sinus cysts is relatively straightforward and carries a good prognosis. In long‐standing cases complications secondary to the expansive growth of cysts will dramatically affect the prognosis for full recovery due to pressure‐induced changes to facial bones, cheek teeth and nerves. These secondary complications mainly occurring in older horses may be due to a combination of a relatively longer period of affection and the inflexibility of older horses’ bones. Cyst recurrence following treatment can occur in up to 19% of cases.

AB - BackgroundParanasal sinus cysts (PSC) are a common cause of equine secondary sinusitis. The outcome and associated complications have not been frequently reported.ObjectivesTo review the associated clinical signs, associated morbidities and outcomes of horses treated for PSC.Study designRetrospective multicentre case series.MethodsRetrospective analysis of case records and telephone follow up survey.ResultsSubjects were 37 horses 1–24 years old that were presented with nasal discharge (n = 31), facial swelling (n = 25) and epiphora (n = 19). Radiography and computed tomography allowed identification of the cyst‐induced changes including concomitant tissue destruction (n = 31), leading among other things to local nerve damage causing headshaking (n = 6) and unilateral blindness (n = 1). Radiographic changes to adjacent dental apices were present in 10 horses. Horses over 10 years old showed more of the named associated problems. Post‐operative complications included surgical site infection (SSI) (n = 11), nasofrontal suture periostitis (n = 6) and sequestration (n = 1) following removal of the PSC via osteotomy.The long‐term response to treatment was available for 28 cases with 22 horses (78.6%) fully cured, 4 (14.3%) partially cured and 2 (7.1%) not responding to treatment. In 7 horses (18.9%) there was recurrence of the cyst post‐operatively.Main limitationsDue to the study being a multicentre retrospective case series with collection of data over an extended period, there may be inconsistency in data recording and absence of reporting of some findings.ConclusionsOverall, the diagnosis and treatment of sinus cysts is relatively straightforward and carries a good prognosis. In long‐standing cases complications secondary to the expansive growth of cysts will dramatically affect the prognosis for full recovery due to pressure‐induced changes to facial bones, cheek teeth and nerves. These secondary complications mainly occurring in older horses may be due to a combination of a relatively longer period of affection and the inflexibility of older horses’ bones. Cyst recurrence following treatment can occur in up to 19% of cases.

KW - horse

KW - nasal discharge

KW - facial swelling

KW - epiphora

KW - headshaking

KW - surgical site infection

KW - suture periostitis

U2 - 10.1111/evj.12959

DO - 10.1111/evj.12959

M3 - Journal article

C2 - 29679404

VL - 51

SP - 57

EP - 63

JO - Equine Veterinary Journal

JF - Equine Veterinary Journal

SN - 0425-1644

IS - 1

ER -