EQUINE SINUS SUTURE PERIOSTITIS: A REVIEW OF CASES FROM A MULTICENTER RETROSPECITIVE STUDY

Sinus suture periostitis, suture exostosis, suture separation, or suturitis is an uncommon condition that should be included in the differential diagnosis of equine facial swelling. Horses affected with suture periostitis develop uni- or bilateral, firm, non-painful swelling in the frontal region of the head. The exact location of the swelling is dependent on the facial sutures affected. The problem is usually diagnosed from clinical signs and radiographs. Radiographs often reveal a radiolucent suture line surrounded by an area of increased opacity and callus formation. Due to the complex 3-D anatomy of the head and problems with superimposition of multiple bony structures, CT offers better imaging of the problem. 59 cases were catalogued. Swelling developed after sinus surgery (20 cases), following trauma to the head (17 cases), reported with underlying sinus pathology (8 cases) or was classified as idiopathic swelling (14 cases). The present case series shows that conservative management of these cases will rarely lead to full clinical resolution of the pathology. Spontaneous disappearance was reported in a number of cases within a 6-month timeframe (except one case where it took 1.5 years), initiating surgical treatment could be delayed in idiopathic cases until after this timeframe. This current case series also demonstrates the importance of the presence of bone sequestrates that may be
involved in the occurrence of suture exostosis.