Equine bilateral frontal sinusotomy

Abstract

A 13 year old Thoroughbred mare presented to the Cornell University Equine Hospital for evaluation of chronic bilateral mucopurulent nasal discharge. She was purchased by the current owner from a sale in 8 months before presentation and at that time had a unilateral serous nasal discharge. The discharge was responsive to antibiotics but would return after medication was discontinued. The discharge progressed to a mucopurulent discharge that became unresponsive to treatment and also became bilateral. The primary veterinarian performed airway endoscopy and sinus radiography that revealed narrowed airways with a mass like lesion in the sinuses. She was referred to Cornell for repeat endoscopy and a CT scan with possible surgical correction of the chronic sinus disease. Upon presentation she was bright, alert and responsive with vital parameters within normal limits. Physical exam revealed bilateral mucopurulent discharge, facial swelling over the left maxillary sinus and stertor. Airflow was decreased through her nasal passages and the left side appeared to be most severely affected. Airway endoscopy revealed swelling of the sinus that was partially obstructing the nasal passage. Large amounts of mucoid discharge were predominant on the left side. A CT revealed a fluid/soft tissue opacity within all the paranasal sinuses on the left and well as the rostral maxillary, ventral conchal and small amounts in the conchofrontal on the right. This case report will discuss the etiology, treatment and prognosis of mucopurulent bilateral nasal discharge with a bilateral frontal sinusotomy in a 13 year old mare.