Equine Suture Exostosis: A Review of Cases from a Multicenter Retrospective Study

Simple summary Suture exostosis is a condition affecting the horse's head. The connections between the bone plates that form the horse's face have been shown to react to insult. Horses will then develop a swelling along the face that may be painful. Little is known about this condition and the present research project aimed to investigate horses presented to equine clinics with symptoms of the disorder. It was revealed that the condition can form following trauma, underlying sinus disease, following a surgery or without any apparent cause. Various treatment options to resolve the condition have been reported and the outcomes of those are described in the paper. Most consistently the proper diagnosis and identification and removal of potential bone sequestra are crucial for a timely resolution. Suture exostosis is an intriguing and not uncommon pathology that has to be included in the differential diagnosis for horses with swelling of the head. Although several singular case reports have been published, no large case series is available. The aim of this study is to report a multicentric retrospective collection of suture exostosis cases. Data concerning horses with suture exostosis in the facial region were collected retrospectively. Information regarding breed, age, gender, history, imaging findings, initiated treatment, response to treatment and follow up was recorded. One hundred and five cases of various breeds were reported. Analysis revealed the cases could be grouped into four entities: 45 developed following sino-nasal surgery, 23 following trauma, seven with underlying sinus pathology and 25 idiopathic. Treatment consisted of sequestra removal, plate fixation, antimicrobial and anti-inflammatory drugs or no treatment. Whereas initial localized pain fades within few days or weeks, resolution or reduction of the swelling was obtained in most cases after 3 months to 1.5 years. The etiopathogenesis of suture exostosis seems to consist of different entities. Identification of an underlying cause, particularly the presence of a bone sequester and infection is important to speed up resolution and before concluding an idiopathic case. When performing sinusotomies, it is important to provide as little trauma as possible to the surgical site in order to prevent suture exostosis as a complication

Functional anatomy of the equine temporomandibular joint: Collagen fiber texture of the articular surfaces

In the last decade, the equine masticatory apparatus has received much attention. Numerous studies have emphasized the importance of the temporomandibular joint (TMJ) in the functional process of mastication. However, ultrastructural and histological data providing a basis for biomechanical and histopathological considerations are not available. The aim of the present study was to analyze the architecture of the collagen fiber apparatus in the articular surfaces of the equine TMJ to reveal typical morphological features indicating biomechanical adaptions. Therefore, the collagen fiber alignment was visualized using the split-line technique in 16 adult warmblood horses without any history of TMJ disorders. Within the central two-thirds of the articular surfaces of the articular tubercle, the articular disc and the mandibular head, split-lines ran in a correspondent rostrocaudal direction. In the lateral and medial aspects of these articular surfaces, the split-line pattern varied, displaying curved arrangements in the articular disc and punctual split-lines in the bony components. Mediolateral orientated split-lines were found in the rostral and caudal border of the articular disc and in the mandibular fossa. The complex movements during the equine chewing cycle are likely assigned to different areas of the TMJ. The split-line pattern of the equine TMJ is indicative of a relative movement of the joint components in a preferential rostrocaudal direction which is consigned to the central aspects of the TMJ. The lateral and medial aspects of the articular surfaces provide split-line patterns that indicate movements particularly around a dorsoventral axis

Extraction of a capped permanent 4th premolar tooth with fistulous tract on a standing sedated horse using minimally invasive intraalveolar dissection - Case report

SUMMARY Background: Extraction of teeth in standing, sedated horses with forceps are well described. In contrast to other methods of extraction like minimally invasive buccotomy, dental repulsion or Steinmann pin repulsion, surgical access through soft tissues or bone is not required for the oral dissection of equine cheek teeth. Objectives: The aim of the current article was to describe a novel extraction technique of equine cheek teeth using endoscopy-guided intra-alveolar dissection with rotating burs. The technique enables tooth removal when dental extraction with forceps is not feasible. To our knowledge this method has only been described in congress abstracts yet.Materials and Methods: A 3-year-old Quarter horse stallion was referred to the clinic with painful, egg-shaped swelling at the right cheek since one tooth had been extracted on the same side about 6 months earlier. On the sedated horse oral camera examination and radiological examination was performed. A fistulous tract extending approximately 70 mm in distoapical direction, reaching the apex of 108, could be probed next to 508 cap. After sedation and cap extraction, the 108 non-erupted was dissected in mesiodistal, sagittal and midline plane with rotating burs and finally fractured with root elevator to be able to remove. During hospitalisation the horse was administered NSAIDs’, AB and wound cleaning with plugs.Results and Discussion: On day 47 the alveolus was completely filled with granulation tissue and the horse went back into training. The swelling disappeared until the 6th month. At the last control (3.75 year after operation) dental drift of 109-111 mesially was diagnosed. A dentin and cementum composed malformed 108 erupted. The 106 tilted distally and closed to the malformed 108. As no inflamed peridental soft tissues were observed, the horse was sound and in training the malformed cheek tooth was not extracted. In general to successfully dissect equine premolar cheek teeth with an intraoral minimally invasive method, sharp burs of varying lengths (25-85 mm) mounted in a 90° angle on a handpiece, coupled to a flexible shaft of an electric engine are required

Bacterial Meningitis After Sinus Surgery in Five Adult Horses.

OBJECTIVE To report meningoencephalitis as a complication after paranasal sinus surgery in 5 horses. STUDY DESIGN Case series. ANIMALS Adult horses (n = 5). METHODS Medical records (2005-2010) of 5 horses that developed neurologic signs after sinus surgery were reviewed to identify potential risk factors, cause(s), or common pathways for infection. RESULTS Underlying diseases were primary (n = 1) and secondary sinusitis (4) because of apical dental infection (1), sinus cyst (2), or masses in the ethmoturbinate region (2). Horses were treated by conventional surgical approaches and aftercare including repeated sinus lavage. Four horses had undulating pyrexia postoperatively despite antimicrobial therapy. All horses developed neurologic signs, eventually unresponsive to treatment. Suppurative meningoencephalitis was diagnosed macro- and/or microscopically on necropsy in all horses. CONCLUSION Meningitis is a rare but fatal complication after sinus surgery in horses