Fenner M F, Verwilghen D, Townsend N, Simhofer H, Schwarzer J, Zani D D, Bienert-Zeit A
Large Animal Hospital, University of Copenhagen, Copenhagen, Denmark.
Equinespecialists EU, Smorum, Denmark.
Equine Vet J. 2019 Jan;51(1):57-63. doi: 10.1111/evj.12959. Epub 2018 May 17.
Paranasal sinus cysts (PSC) are a common cause of equine secondary sinusitis. The outcome and associated complications have not been frequently reported.
To review the associated clinical signs, associated morbidities and outcomes of horses treated for PSC.
Retrospective multicentre case series.
Retrospective analysis of case records and telephone follow up survey.
Subjects were 37 horses 1-24 years old that were presented with nasal discharge (n = 31), facial swelling (n = 25) and epiphora (n = 19). Radiography and computed tomography allowed identification of the cyst-induced changes including concomitant tissue destruction (n = 31), leading among other things to local nerve damage causing headshaking (n = 6) and unilateral blindness (n = 1). Radiographic changes to adjacent dental apices were present in 10 horses. Horses over 10 years old showed more of the named associated problems. Post-operative complications included surgical site infection (SSI) (n = 11), nasofrontal suture periostitis (n = 6) and sequestration (n = 1) following removal of the PSC via osteotomy. The long-term response to treatment was available for 28 cases with 22 horses (78.6%) fully cured, 4 (14.3%) partially cured and 2 (7.1%) not responding to treatment. In 7 horses (18.9%) there was recurrence of the cyst post-operatively.
Due to the study being a multicentre retrospective case series with collection of data over an extended period, there may be inconsistency in data recording and absence of reporting of some findings.
Overall, the diagnosis and treatment of sinus cysts is relatively straightforward and carries a good prognosis. In long-standing cases complications secondary to the expansive growth of cysts will dramatically affect the prognosis for full recovery due to pressure-induced changes to facial bones, cheek teeth and nerves. These secondary complications mainly occurring in older horses may be due to a combination of a relatively longer period of affection and the inflexibility of older horses' bones. Cyst recurrence following treatment can occur in up to 19% of cases.
鼻窦囊肿（PSC）是马继发性鼻窦炎的常见病因。其治疗结果及相关并发症的报道并不常见。
回顾接受PSC治疗的马匹的相关临床症状、合并症及治疗结果。
回顾性多中心病例系列研究。
对病例记录进行回顾性分析，并通过电话随访调查。
研究对象为37匹年龄在1至24岁之间的马，这些马表现出鼻分泌物增多（n = 31）、面部肿胀（n = 25）和流泪（n = 19）。放射学检查和计算机断层扫描能够识别囊肿引起的变化，包括伴随的组织破坏（n = 31），其中导致局部神经损伤，引起摇头（n = 6）和单眼失明（n = 1）。10匹马的相邻齿根尖出现放射学变化。10岁以上的马出现更多上述相关问题。术后并发症包括手术部位感染（SSI）（n = 11）、鼻额缝骨膜炎（n = 6）以及通过截骨术切除PSC后出现的死骨形成（n = 1）。28例病例有长期治疗反应，其中22匹马（78.6%）完全治愈，4匹马（14.3%）部分治愈，2匹马（7.1%）治疗无效。7匹马（18.9%）术后囊肿复发。
由于本研究为多中心回顾性病例系列研究，且数据收集时间较长，可能存在数据记录不一致以及部分结果未报告的情况。
总体而言，鼻窦囊肿的诊断和治疗相对简单，预后良好。在长期病例中，囊肿扩张生长引起的并发症会因对面部骨骼、颊齿和神经的压力性改变而显著影响完全康复的预后。这些主要发生在老年马匹中的继发性并发症可能是由于患病时间相对较长以及老年马匹骨骼缺乏柔韧性共同导致的。治疗后囊肿复发率可达19%。
