Disease Du Jour: Equine Sinuses

The equine sinuses can be affected by disease or injury quite frequently, according to Dr. Alison Gardner of The Ohio State University.
horse skull sinuses showing
Equine sinuses can be affected by disease or injury quite frequently, according to Dr. Alison Gardner, Getty Images

Disease Du Jour is brought to you in 2022 by Merck Animal Health.

In Episode 79 of the Disease Du Jour podcast, we talk to Alison Gardner, DVM, DACVS, an assistant professor in Clinical Equine Surgery, Department of Veterinary Clinical Science, at The Ohio State University, on the topic of Equine Sinuses.

Why equine sinuses? While it seems like an unusual topic, the equine sinuses can be affected by disease or injury quite frequently, according to Gardner,  

“Since horses are obligate nasal breathers, it can be a very important region, especially for athletic horses,” she said.

In this episode Gardner talks about the six pairs of paranasal sinuses—the frontal, sphenopalatine and maxillary sinuses, and the dorsal, middle and ventral conchal sinuses. (The maxillary sinus is the largest paranasal sinus and is divided into two parts—rostral and caudal—by a thin septum.)

Other topics she discussed included:

  • Imaging the sinus area
  • Infections—sinusitis
    • Teeth issues
  • Fungal infections
  • Cancer
  • Progressive ethmoid hematoma
  • Cysts
  • Bleeding
  • Wounds and fractures

When talking about sinus infections, Gardner warned that most horses aren’t “bothered by” this issue. “They usually don’t have a fever or depression,” she said. Gardner added that veterinarians might see inappetence in affected horses. “Most sinusitis is related to tooth issues,” Gardner added.

She noted that because sinuses are separate that often discharge from an infection is unilateral.

“There is a primary sinusitis,” she said. “You are worried when there is a purulent nasal discharge because of the possibility of strangles.”

Another issue with sinuses is fracture. “Horses tend to run into things at high speed or get kicked,” said Gardner.

She warned veterinarians to remember that there are some structures in the sinus region that need to be checked if there is a sinus fracture, including the nasolacrimal duct. “If the nasolacrimal duct is disrupted the horse can end up with chronic discharge.”

The infraorbital nerve also runs through that area. “If that is damaged, it can result in headshaking,” noted Gardner.

She discussed some techniques to “buttress” fractures, especially in young horses. Gardner also talked about sinus fractures in adult horses and the potential of the eye becoming destabilized. She outlined some things that can be done to assist in proper healing.

Gardner also recommended the University of Georgia’s book Anatomy and Diagnostic Imaging of the Equine Paranasal Sinuses. You can access it through Apple books.

She stressed that the biggest thing about equine sinuses is not to get frustrated with the anatomy. Often, she said, the best way to diagnose involvement of the equine sinuses is with CT.

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