Case report: Equine secondary sinusitis with oromaxillary sinus fistula: clinical, diagnostic, and therapeutic considerations

Case report: Equine secondary sinusitis with oromaxillary sinus fistula: clinical, diagnostic, and therapeutic considerations


Abstract

History and clinical presentation: A 16-year-old Thoroughbred gelding presented one month after surgical treatment of a right rostral maxillary sinus (RMS) abscess with unilateral, malodorous, purulent nasal discharge, swelling of the right maxillofacial area and a centrally located cutaneous fistula also with malodorous purulent discharge. The horse was bright and alert upon presentation. Physical exam and haematological parameters were normal.

Diagnosis: Endoscopy and radiography identified an embedded fourth maxillary premolar (108). A diagnosis of secondary maxillary sinusitis with oromaxillary sinus fistula was made.

Treatment: Under standing sedation the rostral maxillary sinus was entered using a 20 mm Galt trephine and lavaged with normal saline followed by 0.01% Povidone Iodine Solution (PIS). Post operatively, the horse was given Cefuroxime (4 mg/ Kg, IV, two times per day for 5 days), Phenylbutazone (1.1mg/ Kg, PO, two times per day for 3 days), and the owner was advised to employ continuous irrigation and lavage through an indwelling lavage system.

Outcome: Upon examination two months post operatively, the wound had completely healed with a slight right maxillofacial deformity.

Conclusions and clinical relevance: The outcome of this case confirmed that standing trephination surgery provides an effective method to treat secondary sinusitis due to dental problems in horses.


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