[en] Background: Sinus gas expansion is a rare condition in equine patients, resulting in progressive deformity of the facial bones. The condition is sparsely documented in veterinary literature. Similar lesions are categorised as sinus pneumocele or pneumosinus dilatans in human patients, based on the presence or absence of sinus wall erosion. Objectives: To describe imaging findings in horses with gas expansion of the paranasal sinuses. Study design: Multicentric retrospective descriptive case series. Methods: Horses with a computed tomographic (CT) description of sinus gas expansion were included. Computed tomography changes were described, and lesions were categorised as sinus pneumocele or pneumosinus dilatans. Signalment, history and clinical signs were recorded, as well as radiological signs, histology and follow-up information, when available. Results: Eight horses met the inclusion criteria, including seven diagnosed with sinus pneumocele and one with pneumosinus dilatans. Clinical signs were variable, depending on the affected bones and sinuses. The conchofrontal sinus was the most frequently affected. Irregular sinus wall erosion, marginal separation of the bone diploe and abnormal septation were consistent imaging findings in horses with sinus pneumocele. Active bone remodelling was confirmed by histology in one patient. Based on CT, the sinus mucosa was thickened adjacent to the sinus wall erosion in 5/7 patients, with hazy dystrophic mineralisation in three horses. One horse had a follow-up CT at 26 months, showing progression of the lesion. The horse with pneumosinus dilatans had minor facial bone deformity and severe gas expansion of all left-sided paranasal sinuses, largely encroaching on the right paranasal sinuses, without bone erosion. Conclusion: Diagnostic imaging and more particularly CT is valuable for identifying and characterising abnormal gas expansion of the paranasal sinuses in horses. Based on this small case series, the condition is slowly progressive and inconsistently associated with clinical signs. Its pathophysiology remains unclear, warranting further exploration.
Disciplines :
Veterinary medicine & animal health
Author, co-author :
Charles, Alexandre ; Université de Liège - ULiège > Fundamental and Applied Research for Animals and Health (FARAH) > FARAH: Médecine vétérinaire comparée
Salciccia, Alexandra ; Université de Liège - ULiège > Département d'Enseignement et de Clinique des Equidés (DCE) > Chirurgie des équidés
van Bergen, T. ; Clinique Equine Acy-Romance, Acy-Romance, France
Pige, C.É.; Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, United States
Launois, T.; Clinique Équine Des Perdreaux, Bréval, France
Robert, M. ; Centre Hospitalier Vétérinaire Équin du Livet, Saint-Michel-de-Livet, France
Busoni, Valeria ; Université de Liège - ULiège > Fundamental and Applied Research for Animals and Health (FARAH) > FARAH: Médecine vétérinaire comparée
Evrard, Laurence ; Université de Liège - ULiège > Département d'Enseignement et de Clinique des Equidés (DCE) > Imagerie médicale des équidés ; VetCT, St John's Innovation Centre, Cambridge, United Kingdom
Language :
English
Title :
Imaging diagnosis and clinical outcomes of eight horses with sinus gas expansion
Abdel-Aal, A.K., Abayazeed, A.H., Raghuram, K. & Curé, J.K. (2010) Pneumocele of the frontal sinus producing orbital roof defect: case report and review of literature. American Journal of Otolaryngology, 31, 202–204.
Adams, W.M., Jones, R.I., Chavda, S.I., Pahor, A.L. & Taifa, K.T. (1998) Pneumosinus dilatans: a discussion of four cases and the possible aetiology. Rhinology, 36, 40–42.
Alatar, A.A., AlSuliman, Y.A., Alrajhi, M.S. & Alfawwaz, F.S. (2019) Maxillary Pneumosinus Dilatans presenting with Proptosis: a case report and review of the literature. Clinical Medicine Insights Ear Nose Throat, 12, 1179550618825149.
Ambo, M., Kumakiri, M. & Chohno, Y. (2003) Epidermoid cyst with perforation of the skull. Journal of the American Academy of Dermatology, 49, 934–936.
Benedikt, R.A., Brown, D.C., Roth, M.K., Geyer, C.A. & Ghaed, V.N. (1991) Spontaneous drainage of an ethmoidal mucocele: a possible cause of pneumosinus dilatans. American Journal of Neuroradiology, 12, 729–731.
Breuer, W., Löscher, N. & Hermanns, W. (2005) Paranasal sinus pneumocele in a horse. Pferdeheilkunde, 21, 293–296.
Choi, E.C., Shin, H.S., Nam, S.M., Park, E.S. & Kim, Y.B. (2011) Surgical correction of pneumosinus dilatans of maxillary sinus. The Journal of Craniofacial Surgery, 22, 978–981.
Cissell, D.D., Wisner, E.R., Textor, J., Mohr, F.C., Scrivani, P.V. & Théon, A.P. (2012) Computed tomographic appearance of equine sinonasal neoplasia. Veterinary Radiology & Ultrasound: The Official Journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association, 53, 245–251.
Conradie, M., Robert, M. & Carstens, A. (2022) Radiographic and CT features of zygomatic arch pneumatization in a thoroughbred with a recurrent progressive ethmoid hematoma. Veterinary Radiology & Ultrasound, 63, e1–e5.
Dixon, P.M. (2014) A review of swellings of the frontal region of the equine head. Equine Veterinary Education, 26, 365–371.
Gomez, C.K., Schiffman, S.R. & Bhatt, A.A. (2018) Radiological review of skull lesions. Insights Into Imaging, 9, 857–882.
Gunnarsdottir, H., Chiers, K., Praet, M., Saunders, J., Schauvliege, S. & Vlaminck, L. (2014) Epithelial inclusion cysts of the frontal bones in three horses. Equine Veterinary Education, 26, 357–361.
Harrison, M.S. (1955) Pneumosinus frontalis. The Journal of Laryngology and Otology, 69, 108–114.
Jankowski, R., Kuntzler, S., Boulanger, N., Morel, O., Tisserant, J., Benterkia, N. et al. (2014) Is pneumosinus dilatans an osteogenic disease that mimics the formation of a paranasal sinus? Surgical and Radiologic Anatomy, 36, 429–437.
Karadag, D., Calisir, C. & Adapinar, B. (2008) Post-traumatic Pneumocele of the frontal sinus. Korean Journal of Radiology, 9, 379–381.
Karlıdağ, T., Yalçın, Ş., Kaygusuz, İ. & Demirbağ, E. (2003) Bilateral pneumosinus dilatans of the maxillary sinuses. British Journal of Oral and Maxillofacial Surgery, 41, 122–123.
Kiroglu, Y., Karabulut, N., Sabir, N.A., Yagci, A.B., Gakmak, V. & Ozguler, U. (2007) Pneumosinus dilatans and multiplex: report of three rare cases and review of the literature. Dento Maxillo Facial Radiology, 36, 298–303.
Kuntzler, S. (2012) Aux frontières du développement sinusien: de l'arrêt de pneumatisation au pneumosinus dilatans. non renseigné.
Lane, J.G., Gibbs, C., Meynink, S.E. & Steele, F.C. (1987) Radiographic examination of the facial, nasal and paranasal sinus regions of the horse: I. Indications and procedures in 235 cases. Equine Veterinary Journal, 19, 466–473.
Lombardi, G., Passerini, A. & Cecchini, A. (1968) Pneumosinus Dilatans. Acta Radiologica: Diagnosis (Stockh.), 7, 535–542.
Mahesh, M. (2013) The essential physics of medical imaging, third edition. Medical Physics, 40, 077301.
Manso-Díaz, G., García-López, J.M., Maranda, L. & Taeymans, O. (2015) The role of head computed tomography in equine practice. Equine Veterinary Education, 27, 136–145.
Marqués, F.J., Sharma, A. & Wilson, D.G. (2012) Investigation of a progressive facial deformity and stridor in an adult horse with a bone sequestrum and subsequent sinonasal abscess. Canadian Veterinary Journal, 53, 653–658.
Mauri, M., de Oliveira, C.O. & Franche, G. (2000) Pneumosinus dilatans of the maxillary sinus. Case report. The Annals of Otology, Rhinology, and Laryngology, 109, 278–280.
Meyer, U., Kruse-Lösler, B. & Wiesmann, H.P. (2006) Principles of bone formation driven by biophysical forces in craniofacial surgery. British Journal of Oral and Maxillofacial Surgery, 44, 289–295.
Meyes, J. (1898) Pneumosinus dilatans. Nederlands Tijdschrift voor Geneeskunde, 11, 143–148.
Mortazavi, H., Baharvand, M. & Safi, Y. (2022) Scalloped border as a possible diagnostic aid for differentiating jaw lesions: a pictorial essay. Imaging Science in Dentistry, 52, 309–317.
Nottle, B.F., Tatarniuk, D.M., Caldwell, F.J., Bell, C.D., Caston, S.S., Merkatoris, P.T. et al. (2021) Fibro-osseous lesions of the craniofacial complex in horses: 30 cases (2001–2019). Veterinary Surgery, 50, 383–392.
Ostrowska, J., Lindström, L., Tóth, T., Hansson, K., Uhlhorn, M. & Ley, C.J. (2020) Computed tomography characteristics of equine paranasal sinus cysts. Equine Veterinary Journal, 52, 538–546.
Ricci, J.A. (2017) Pneumosinus Dilatans: over 100 years without an etiology. Journal of Oral and Maxillofacial Surgery, 75, 1519–1526.
Rossi, A., Fondelli, M.P., Piatelli, G.L., Gandolfo, A., Borasi, F. & Donati, P.T. (1996) Progressive Dyspneumatization of a frontal sinus from Pneumosinus Dilatans to Pneumocele. Rivista di Neuroradiologia, 9, 227–231.
Sommer, F. (2021) Rare diseases of the nose, the paranasal sinuses, and the anterior Skull Base. Laryngo-Rhino-Otologie, 100, S1–S44.
Stenberg, T., Dowling, B. & Dart, A. (2004) Mandibular bone cysts in two horses. Australian Veterinary Journal, 82, 417–418.
Teh, B.M., Hall, C. & Chan, S.W. (2012) Pneumosinus dilatans, pneumocoele or air cyst? A case report and literature review. The Journal of Laryngology and Otology, 126, 88–93.
Textor, J.A., Puchalski, S.M., Affolter, V.K., MacDonald, M.H., Galuppo, L.D. & Wisner, E.R. (2012) Results of computed tomography in horses with ethmoid hematoma: 16 cases (1993–2005). Journal of the American Veterinary Medical Association, 240, 1338–1344.
Twede, J.V., Patterson, M.C. & Anderson, M.L. (2018) Intraosseous epidermoid cyst of the skull: case study and radiological imaging considerations. Dermatology Online Journal, 24, 13030/qt5712f7zb.
Urken, M.L., Som, P.M., Lawson, W., Edelstein, D., Weber, A.L. & Biller, H.F. (1987) Abnormally large frontal sinus. II. Nomenclature, pathology, and symptoms. The Laryngoscope, 97, 606–611.
van Delft, T.V.A.F., Pollaris, E., Gielen, I., Vanderperren, K., Tuerlinckx, L. & Vlaminck, L. (2018) Maxillary bone cysts in two horses: diagnosis and treatment including intralesional formalin injection. Equine Veterinary Education, 30, 583–590.
van Schayck, R. & Niedeggen, A. (1992) Pneumosinus dilatans after prolonged cerebrospinal fluid shunting in young adults with cerebral hemiatrophy. A report of two cases and review of the literature. Neurosurgical Review, 15, 217–223.
Verwilghen, D., Easley, J., Zwick, T., Uhlhorn, M., Grulke, S., Simhofer, H. et al. (2022) Equine suture exostosis: a review of cases from a multicenter retrospective study. Veterinary Science, 9, 365.
Walker, J.L. & Jones, N.S. (2002) Pneumosinus dilatans of the frontal sinuses: two cases and a discussion of its aetiology. The Journal of Laryngology and Otology, 116, 382–385.
White and Pharoah's Oral Radiology. (2018) White and Pharoah's Oral Radiology, 8th Edition – 9780323543835. Available from: https://evolve.elsevier.com/cs/product/9780323543835?role=student [Accessed 1st August 2024].
Wolfman, D.E. & Tinling, S.P. (1993) Systemic osteoclast activation by localized pressure. Archives of Otolaryngology – Head & Neck Surgery, 119, 165–168.
Zhao, C., Zhao, Y., Yang, J. & Wang, Z. (2019) Two rare cases of maxillary pneumocoele. British Journal of Oral and Maxillofacial Surgery, 57, 590–593.
