Sinus disease in the horse is often diagnosed after horse owners notice nasal discharge, deformation of the facial bones, a foul odor from the nose or mouth, or in conjunction with dental disease diagnosed during routine oral examination by the primary care veterinarian. Sinus disease comes in many forms, including infection, cyst formation, hematomas, traumatic injuries, or even tumors.
The horse has many large paranasal sinus cavities separated by only thin portions of bone from their large constantly erupting teeth, the airway, and the skin of their faces. One common misconception is that sinus disease is only seen in older horses, which is not the case! While many cases of sinus infection are seen in older horses due to extension of infection from diseased teeth, younger and middle aged horses are certainly subject to sinus cyst development, infection, or extension of hematomas from the ethmoid turbinates into the sinus cavities. Furthermore, traumatic injury to the sinuses can happen to any horse at any time.
We offer the gamut of diagnostics to investigate the nature of suspected sinus disease including radiographs, flexible nasal endoscopy, computed tomography (CT, “cat scan”) which gives essentially cross sectional images and 3-D reconstruction of the region, or invasive diagnostics including sinoscopy (inserting an endoscope directly into the sinus cavity) or sinus flap surgery which includes making a small bone flap into the sinus to explore, diagnose, and potentially treat the sinus disease. Many of these diagnostics and surgical treatments can be performed in the standing horse, while others are best performed under general anesthesia. Those decisions are made on a case by case basis.