Fixation of chronic suture exostosis in a mature horse

Abstract

This case report describes the clinical findings, diagnosis and treatment of a 14-year-old Warmblood gelding with suture exostosis. The horse was referred to our clinic because of bilateral swelling in the region of the frontal and nasal bone junction and bilateral epiphora. Epiphora was the main concern for the owner and the reason for further investigation and treatment. Radiographic examination showed extensive bone proliferation on the dorsal frontal and nasal bones. Computed tomographic (CT) images further characterised the periosteal proliferation as new bone formation and localised it along the frontonasal and frontolacrimal suture lines. Computed tomographic images also showed pathological changes of both lacrimal ducts. A chronic fracture was suspected to be the cause of the periosteal proliferation, and surgical treatment using 2 small 2.4 Unilock plates was chosen to stabilise the suture between the frontal and nasal bones. The swelling decreased and the epiphora resolved by 6 months post operatively. A CT examination 2 years later showed complete healing. (arrows) are stable and bone proliferations along the nasofrontal suture associated with the chronic fracture have disappeared. (b) Three-dimensional reconstruction computed tomography image 2 years after surgery showing normal structure of the suture. The implants (arrows) and the trepanation hole (arrowhead) are visible. Fig 7: (a) Transverse computed tomography image at the level of the second molars two years after surgery; bone window; left side to the right of the image. There is chronic sinusitis with bone sclerosis of the right rostral maxillary sinus. The right lacrimal duct (arrowhead) appears normal. Implants

Suture exostosis with concurrent nasal septum chondrosarcoma in a horse

“…; Klein et al . ). Equine skull sutures fuse over the first few months of life and become obliterated or ossified between 3 months and 5 years of age (Butler et al .…”

“…; Klein et al . ). The nasofrontal suture is the most commonly involved suture, although the nasolacrimal, lacrimo/zygomaticomaxillary and internasal sutures can be affected (Lane et al .…”

“…; Klein et al . ). Because the nasolacrimal duct is attached to the ventral aspect of the frontal and nasal bones, thickening of the periosteum, bone remodelling and local inflammation often result in unilateral or bilateral epiphora in affected horses (Carslake ; Manso‐Díaz and Taeymans ; Klein et al .…”

“…Because the nasolacrimal duct is attached to the ventral aspect of the frontal and nasal bones, thickening of the periosteum, bone remodelling and local inflammation often result in unilateral or bilateral epiphora in affected horses (Carslake ; Manso‐Díaz and Taeymans ; Klein et al . ). The radiographic appearance of suture exostosis consists of periosteal reaction around the suture line accompanied by lysis of the affected suture (Lane et al .…”

“…Computed tomography examination can further characterise the lesions (Manso‐Díaz and Taeymans ; Klein et al . ).…”