Equine diseases encompass a wide range of health conditions that can affect horses, including infectious diseases, metabolic disorders, and genetic conditions. These diseases can impact the overall health, performance, and well-being of horses. Common equine diseases include equine influenza, equine herpesvirus, laminitis, and equine metabolic syndrome. Diagnosis and management of these diseases often require a combination of clinical evaluation, laboratory testing, and appropriate treatment strategies. This page gathers peer-reviewed research studies and scholarly articles that explore the etiology, pathophysiology, diagnosis, and treatment options for various equine diseases, providing valuable insights for veterinarians and researchers in the field.
Zamos DT, Ford TS, Cohen ND, Crossland LE.Two mares developed segmental ischemic necrosis of the small intestine after parturition. In one mare, the mesentery of the small intestine apparently tore during parturition, after which necrosis developed in a 52-cm segment of the distal portion of jejunum. In the other mare, a 52-cm segment of the proximal portion of ileum tore during parturition. Three weeks later, a 40-cm segment of the distal portion of jejunum became incarcerated in the mesenteric rent and twisted 360 degrees on its mesentery. Both mares recovered after resection of affected intestine and are functioning as broodmares.
Rodriguez M, Hooghuis H, Castaño M.African horse sickness (AHS) is an infectious, non-contagious, highly fatal viral disease of Equidae, transmitted by arthropod vectors of the genus Culicoides, and endemic in Africa south and east of the Sahara. The disease is caused by a virus of the Reoviridae family, genus Orbivirus, and 9 serotypes have been recognized. Recent outbreaks of AHS in the Iberian peninsula and Northern Africa emphasize the need for accurate diagnosis and rapid implementation of control measures. In this paper, the epizootiological factors, clinical signs and necropsy findings of AHS are discussed, and an update...
Lunn DP.Monoclonal antibody technology has allowed the recognition and study of numerous leucocyte antigens in man and laboratory animals for over a decade. Numerous advances in the understanding of immune responses and immunopathology have resulted. In recent years equine researchers have started to develop similar reagents, which now offer a powerful tool to investigators of equine immunology and disease.
Granstrom DE, Dubey JP, Davis SW, Fayer R, Fox JC, Poonacha KB, Giles RC, Comer PF.Antigens of cultured Sarcocystis neurona merozoites were examined using immunoblot analysis. Blotted proteins were probed with S. cruzi, S. muris, and S. neurona antisera produced in rabbits, S. fayeri (pre- and post-infection) and S. neurona (pre- and post-inoculation) sera produced in horses, immune sera from 7 histologically confirmed cases of equine protozoal myeloencephalitis (EPM), and pre-suckle serum from a newborn foal. Eight proteins, 70, 24, 23.5, 22.5, 13, 11, 10.5, and 10 Kd, were detected only by S. neurona antiserum and/or immune serum from EPM-affected horses. Equine sera were ...
Wilkins PA, Lowe JE.Right dorsal colon fistulas, 2.5 cm in diameter, were created in 2 healthy ponies, using a 2-stage surgical procedure. The first stage consisted of resection of portions of the 16th and 17th ribs on the right side, followed by surgical creation of a 6- to 8-cm-diameter adhesion between the right dorsal colon and the body wall. Fistulas were created approximately 2 weeks after the first surgery by sharp dissection through the adhesion into the lumen of the colon. The fistulas have been satisfactorily maintained for > 2 years by de Pezzer catheters (45 F). Ponies with fistulas have been used ...
Lepage OM, Laverty S, Drolet R, Lavoie JP.A case of infiltrative lipoma in the left flank of a yearling Quarter Horse is described. Rectal palpation, percutaneous ultrasonographic examination, the marbled appearance and poor delineation from surrounding tissues strongly suggested an infiltrative lipoma. This was confirmed by histological examination. Infiltrative lipomas should be included in the differential diagnosis of soft masses located in equine muscle.
Lew AM, Thomas LM, Huntington PJ.Sera of sixteen horses with clinical signs of EIA from six different outbreaks and sera of 100 uninfected horses were used to validate an ELISA for EIA diagnosis. The antigen used was a recombinant protein derived from the amino-terminal portion of the transmembrane envelope protein of EIA (gp45). Reactivity between positive and negative sera could be clearly distinguished. Comparison with the traditional agar gel immunodiffusion test (commonly called the Coggins test) showed that the ELISA was superior in sensitivity. Comparison of this ELISA with the FAST-ELISA system showed that the latter ...
Montavon S.Few scientists predicted the impact that echography would have on the equine breeding industry. The aim of this practical review is to give the practitioner the ability to be familiar with the ovarian echographic exam. He should be able to recognize different stages of estrous cycle in the mare, status of preovulatory follicles and to predict precisely the time of ovulation. Various specific criteria and details regarding the equine echography are studied and illustrated, using the last scientific data published after the Fifth International Symposium on Equine Reproduction in Deauville.
Hunt RJ.Case records of 202 horses treated for laminitis were reviewed with the intent of determining the long-term outcome and correlating this with digital radiographic findings and with the degree of pain associated with the laminitis. At long-term follow-up 57 horses had returned to athletic soundness (Group 1), 20 horses were intermittently lame (Group 2), 19 horses had permanent severe lameness (Group 3), 97 were dead (Group 4), and 9 were lost to follow up. Using simple regression analysis, functional outcome did not correlate with the degree of rotation (R2 = 0.004) or the presence of distal d...
Poole AW, Heath MF, Sage SO, Evans RJ.Equine platelets in platelet-rich plasma were incubated with the fluorescent indicator dye, Fura-2-AM (Fura-2-acetoxymethyl ester) and the degree of loading of the cells with the dye and the extent of hydrolysis of the ester was assessed by quantitative fluorimetry and by thin-layer chromatography respectively. Under these conditions the cells loaded poorly with Fura-2 to a concentration of 4 microM. The technique was validated by demonstrating adequate loading of human platelets with Fura-2, to a concentration of 250-300 microM, using the same method. The removal of plasma from the extracellu...
Kramer J, Tornquist S, Erfle J, Sloeojan G.Large granular lymphocytes (LGL) occur as a leukemic or aleukemic neoplasia in humans,(1) rats,(2) cats,(3,4) dogs,(5) and horses.(6) The single case of equine LGL previously reported was aleukemic.(5) In contrast to this previous report of aleukemic equine LGL neoplasia, the leukemia in the case presented here established the antemortem diagnosis of LGL.
Chambers JP, Livingston A, Waterman AE, Goodship AE.This study was undertaken to assess the analgesia provided by detomidine (20 micrograms kg-1 intravenously) in thoroughbred horses. Pain thresholds to a mechanical noxious stimulus were measured before and after a period of mild chronic pain in one foreleg. Detomidine was a good analgesic in control animals; their pain thresholds were significantly elevated for about 60 minutes. After injury, the injured leg had a significantly lower pain threshold and the intensity and duration of analgesia provided by detomidine were significantly reduced. The analgesia in the opposite (sound) leg was also r...
van den Bogert AJ, Schamhardt HC.Multi-body models of musculoskeletal systems can be used to determine internal forces from measured external forces and movements ('inverse dynamics') and to perform simulations of movements using muscle forces or activations as input ('direct dynamics'). Examples of 'direct' simulations of movements in the horse are presented. With a model of the equine hindlimb, the function of the 'passive stay apparatus' could be explained. A model of the forelimb was used to determine force distributions in the digital flexor tendons, and to experiment with various methods to change the force distribution...
Imagawa H, Tanaka T, Sekiguchi K, Fukunaga Y, Anzai T, Minamoto N, Kamada M.Electropherotypes (ET), serotypes, and subgroups of equine rotaviruses isolated from foals in Japan were determined. The ETs of 136 isolates from 1981 through to 1991 were divided into six groups: ET-A-ET-F. The ET-A, -B, -C, -D, -E, and -F were present in 3, 1, 121, 9, 1, and 1 strains, respectively. Representative viruses of ET-A, -B, -C, and -D were identified as serotype G3. Viruses of ET-E and -F were identified as serotypes G 10 and G 5, respectively. The four representative viruses of serotype G 3 did not belong to either subgroup I or II. The two viruses of serotypes G 5 and G 10 belon...
Makra Z, Csereklye N, Riera MM, McMullen RJ, Veres-Nyéki K.In this controlled, blinded, randomized block pilot study, the main objective was to evaluate the effectiveness of intravenous flunixin meglumine, phenylbutazone, and acupuncture on ocular pain relief using a multifactorial pain scale in the horse. Four experimental horses underwent corneal epithelial debridement in four sessions, when a randomly selected treatment or a control was used. All horses were pain scored before corneal wounding, then at 18 time points, when 11 parameters were allocated. Differences in the area under the curve of pain scores between the treatment groups were analyzed...
Kwok WH, Leung DK, Leung GN, Wan TS, Wong CH, Wong JK.A rapid liquid chromatography-tandem mass spectrometry (LC-MS-MS) method was developed for the simultaneous screening of 19 drugs of different classes in equine plasma using automated on-line solid-phase extraction (SPE) coupled with a triple quadrupole mass spectrometer. Plasma samples were first protein precipitated using acetonitrile. After centrifugation, the supernatant was directly injected into the on-line SPE system and analysed by a triple quadrupole LC-MS-MS in positive electrospray ionisation (+ESI) mode with selected reaction monitoring (SRM) scan function. On-line extraction and c...
Liuti T, Daniel CR, Dixon PM, Reardon RJM.Cheek teeth (second through fourth premolars and first through third molars) diastema is a common and painful equine disorder caused by the absence of effective tight interdental contact between these teeth. Limited objective information is available on the angulation of equine cheek teeth that control dental drift or on mesial or distal equine cheek teeth drift that should normally prevent this disorder. Objective: To measure the angulation of the mesial and distal cheek teeth in horses of different ages, quantify age-related cheek teeth mesial and distal dental drift, and measure the cheek t...
Liu IK, Pascoe DR, Chang LW, Zee YC.Serum antibody concentrations against influenza A-equi-1 virus and A-equi-2 virus were measured in a group of 18 foals from birth to 4 months of age. More than 50% of the foals were seronegative to A-equi-1 virus infection by 4 weeks of age, with titers of less than or equal to 1:16. For A-equi-2 virus, more than 50% of the foals were seronegative by 2 weeks of age, with titers of less than or equal to 1:8. Passively derived antibodies against influenza A-equi-1 virus and A-equi-2 virus in foals obtained from recently vaccinated mares and from mares not vaccinated within 6 months before foalin...
Stewart HL, Werpy NM, McIlwraith CW, Kawcak CE.To describe the effects of distal limb immobilization and remobilization in the equine metacarpophalangeal joint. Methods: Randomized, prospective experimental study. Methods: Eight healthy, skeletally mature horses. Methods: One forelimb of each horse was immobilized in a fiberglass cast for 8 weeks; this was followed by 12 weeks of a treadmill-based training program after the cast had been removed. Clinical examinations, radiography, computed tomography (CT), nuclear scintigraphy, MRI, and histomorphometry were used to examine the third metacarpal (MC3), proximal phalanx, proximal sesamo...
Di Filippo PA, Dias Meireles MA, Ribeiro LMF, de Lannes ST, Meireles NFT, Viana IS, Hokamura HK.In this study, the effect of early exercise, age, body weight (BW), and growth on the articular cartilage and subchondral bones of the tarsocrural joints was evaluated in 40 young Mangalarga Marchador horses allowed free choice exercise in pasture. Twenty of the horses had additional controlled exercise 3 days per week from a mean age of 30 ± 20 days until 36 months. The training program consisted of an increasing number of 15-minute gallop sprints in an oval paddock with a concrete floor covered by a thick layer of sand. BW, withers height (WH), and neck circumference were measured and bo...
Yu M, Robinson NE, Wang Z, Derksen FJ.The effects of epithelial removal and cyclooxygenase inhibition on contractions induced by exogenous acetylcholine (ACh) and electrical field stimulation (EFS) were evaluated in horse tracheal strips and bronchial rings. Epithelial removal potentiated the response to ACh but had no influence on the response to EFS. The effect of epithelial removal was not altered by pretreating the tissues with meclofenamate, a cyclooxygenase inhibitor. In trachealis strips, meclofenamate augmented contractions induced by EFS but not by ACh. In bronchial rings, meclofenamate augmented EFS-induced contraction t...
Lustgarten M, Redding WR, Schnabel LV, Prange T, Seiler GS.Navigational ultrasound imaging, also known as fusion imaging, is a novel technology that allows real-time ultrasound imaging to be correlated with a previously acquired computed tomography (CT) or magnetic resonance imaging (MRI) study. It has been used in man to aid interventional therapies and has been shown to be valuable for sampling and assessing lesions diagnosed with MRI or CT that are equivocal on ultrasonography. To date, there are no reports of the use of this modality in veterinary medicine. Objective: To assess whether navigational ultrasound imaging can be used to assist commonly...
Mason DK, Watkins KL, McNie JT, Luk CM.In late November 1988 large numbers of thoroughbred horses in training in Hong Kong developed a transient pyrexia with, in some cases, the clinical signs of viral respiratory disease. Serial blood samples for haematological examination were taken from 10 of the horses which were stabled in six different blocks. They had developed a high temperature within three days of each other and subsequently seroconverted to equine herpes virus 1 (EHV1). The absolute monocyte count was more than 0.5 x 10(9)/litre in all 10 within the first five days, and nine of them had a high neutrophil/lymphocyte ratio...
Ross MW.Cecal impaction and cecal perforation, the two most common equine cecal diseases, are thought to develop after slowing or interruption of a single progressive motility pattern, which begins in a pacemaker area near the apex, occurs once every 3 minutes, and propels ingesta from the cecum to the right ventral colon. Rectal examination in horses with cecal impaction is the most useful technique to grade the severity of the condition. Medical treatment is undertaken if the impaction is judged to be mild to moderate. Surgical correction of cecal impaction in severe cases requires a ventral midline...
Tam K, Rezende M, Boscan P.To compare and correlate right atrial pressure, which represents central venous pressure (CVP) to jugular vein pressure (JVP) in laterally recumbent horses under anesthesia. Methods: Retrospective clinical trial. Methods: Seven adult healthy horses (411 ± 8.7 kg). Methods: Horses were sedated with IV xylazine and anesthesia was obtained with IV ketamine and diazepam. Anesthesia was maintained with sevoflurane in oxygen. All horses were positioned in left lateral recumbency. An 8F catheter introducer was inserted into the right jugular vein to measure JVP. An 8F catheter introducer was i...
Dyson DH, Pascoe PJ, McDonell WN.The purpose of this study was to determine the heart rate (HR) and blood pressure (BP) effect of glycopyrrolate in anesthetized horses with low HR ( 5 beats/min within 10 min), glycopyrrolate (same dose) was administered. Heart rate increased by > 5 beats/min in 3 out of 9 horses following the initial glycopyrrolate treatment. Overall changes in HR and mean BP were not significantly different, while systolic and diastolic BP increased significantly (P 5 beats/min, which was significant. A significant increase in BP was produced following treatment with 2.5 micrograms/kg BW, but not followi...
Boone LH, DeGraves FJ, Klein CE, Cole RC, Schumacher J.To assess onset of analgesia for 3% chloroprocaine hydrochloride and 2% mepivacaine hydrochloride when used for median and ulnar nerve blocks in lame horses. Methods: 6 naturally lame horses. Methods: A crossover experiment was conducted. Horses were assigned to 1 of 2 treatment groups (3% chloroprocaine or 2% mepivacaine first). Median and ulnar nerve blocks were performed in the lame limb with the assigned treatment. Lameness was objectively evaluated before treatment administration and at various points for 120 minutes after treatment with a wireless inertial sensor-based motion analysis sy...
Arora S, Sharma S, Goel SK, Singh US.Implementation of the recommended post-exposure prophylaxis by vaccination and specific immunoglobulin therapy for rabies is largely hampered by its high cost and inadequate production. Therefore, the development and availability of an economic preparation of rabies immunoglobulin is a high priority for India, where rabies is a major cause of death. We studied the efficacy of four different adjuvants in raising antibodies to rabies antigen in older, discarded equines. Methods: Eleven equines, 23-26 years old, were divided into 4 groups to receive four different adjuvants in small amounts (1-2 ...
Naylor JM, Bell R.Orphan foals are best reared by fostering them onto a brood mare of appropriate size. If no foster mother is available, they can be reared on 2 per cent fat skimmed cow's milk fortified with dextrose at the rate of 20 gm per L. This should be slowly increased from 10 per cent of body weight at 1 day of age to 25 per cent of body weight at 10 days of age. The amount should then be held constant until weaning. Alternatively, foals can be reared on milk replacers. Manufacturers' feeding instructions rarely mimic the milk intake obtained by a foal nursing her dam, and problems have been observed i...
De Paolis L, De Ciucis CG, Peletto S, Cappelli K, Mecocci S, Nervo T, Guardone L, Crescio MI, Pietrucci D, Fruscione F, Gabbianelli F, Turco S....Papillomavirus (PV) infections may be related to anogenital lesions and cancer development in humans and several other animal species. To date, 11 different PVs have been reported in horses. Among them, a newly described PV named Papillomavirus Type9 (EcPV9) was thus far only reported in the semen of a stallion with penile lesions in Australia. This study reports for the first time the presence of EcPV9 in asymptomatic Italian horses. From July 2020 to January 2022, genital brush samples were collected from 209 horses with no apparent signs of neoplastic disease and no PV-associated lesions, ...
Fürst AE, Lischer CJ.Many disorders affect the equine foot, and many hoof problems have multiple predisposing causes. Surgery may be necessary after conservative management has failed. Diseases of the hoof capsule may seem simple, but their effect on performance can be long-lasting and healing is often prolonged. Diagnosis of problems within the hoof capsule is enhanced with the use of computed tomography and MRI. The prognosis of fractures has improved with strategic placement of lag screws across fracture planes using aiming devices and advanced intraoperative imaging techniques. Collaboration between the clinic...
Sanada Y, Noda H, Nagahata H.A fluorometric assay was applied to evaluate blastogenesis of equine lymphocytes. Optimal culture conditions were as follows; concentrations of phytohaemagglutinin-P (PHA), concanavalin A (Con A) and pokeweed mitogen (PWM) were 1 microgram/ml, 40 micrograms/ml and 10 micrograms/ml, respectively, when 5 X 10(5) lymphocytes were incubated with culture medium containing 20% pooled horse serum (PHS) for 120 hours. The relative mean stimulation index of healthy non-pregnant mares were 5.107 +/- 0.323 (M +/- SE) with PHA, 4.019 +/- 0.183 with Con A and 3.610 +/- 0.131 with PWM. Sequentially the blas...
Steinfort S, Obach-Schröck C, Röcken M, Theiss F, Failing K, Vogelsberg J, Staszyk C.Equine periodontal disease (ePD) usually starts with food impaction, formation of diastemata, gingival inflammation and formation of periodontal pockets. This process proceeds toward the dentoalveolar space, causing detachment of tooth supporting periodontal fibers. Although several therapeutical procedures have been proposed, ePD is often only diagnosed in advanced stages, requiring dental extraction. A similar dilemma has been observed in small animal medicine, but has been overcome by the introduction of reliable examination protocols for the early diagnosis of periodontal diseases (PD). Th...
Peterson C, Driskell E, Wilkie D, Premanandan C, Hamor R.Expression of the 70-kDa heat-shock protein (HSP70) has been demonstrated in normal canine corneal epithelium, and inducible expression has been suggested to facilitate wound resolution through organized migration, proliferation, and adhesion of the corneal epithelial cells. Diminished expression of HSP70 may therefore contribute to prolonged healing in the pathologic cornea of other companion animal species, including the horse. Methods: Normal and pathologic equine cornea was evaluated to determine whether the expression of HSP70 is correlated with appropriate corneal epithelial wound healin...
Walters KW, Corbin CJ, Anderson GB, Roser JF, Conley AJ.Estrogen production by the preimplantation equine embryo is presumed to be important in maternal-conceptus communication in the mare. The synthesis of C(18) estrogens from C(19) androgens requires cytochrome P450 aromatase (P450(arom)) in the conceptus, but little information is available on the specific tissue location or potential developmental patterns of expression for the horse. The goal of this research was to localize P450(arom) in the equine conceptus by immunocytochemistry and in situ hybridization. Intact blastocyst-stage embryos were collected by nonsurgical flush on Days 12-15 of p...
Hallamaa RE, Batchu KC, Tallberg T.Equine summer eczema, also known as insect bite hypersensitivity, affects horses recurrently during summer months. The treatment of this allergic pruritus is difficult and therefore there is a need for efficacious treatments. Autoserum therapy, based on the use of autogenous serum that is specifically prepared for oral administration and given when the animal shows clinical signs has been introduced recently. Lipids are thought to be responsible for the effect of this therapy. Objective: The main aim of this study was to analyse the phospholipid content of autogenous serum preparations and to ...
Frank N, Sojka J, Messer NT.Hypothyroidism is the most common type of thyroid gland dysfunction reported in horses. Primary, secondary, and tertiary causes of hypothyroidism are discussed. Equine hypothyroidism remains a controversial endocrine disorder because extrathyroidal factors, including the administration of drugs and systemic diseases, affect serum triiodothyronine (T3) and thyroxine (T3) concentrations in horses. Accurate diagnosis of hypothyroidism therefore requires assessment of the hypothalamic-pituitary-thyroid axis. Diagnostic procedures for evaluating thyroid gland function are outlined and results of st...
Boyd EH, Allen WE.Plasma concentrations of neomycin were measured following intrauterine infusion of 3.3 mg/kg bodyweight neomycin sulphate. Mares in oestrus absorbed approximately 6 per cent of neomycin infused whereas mares in a luteal phase absorbed 56 per cent. The volume of infusate also affected absorption as increased volume resulted in decreased absorption. The decreased absorption both during oestrus and when large volumes were used was probably due to reflux of antibiotic through the cervix.
Ameni G.Epizootic lymphangitis (EL) was experimentally reproduced in four horses that had been purchased from an EL-free district. Two horses were injected with either 0.2 mL of the yeast form of Histoplasma capsulatum var. farciminosum (HCF) in pus (Horse 1), or 0.2 mL (ca. 20 mg) of a suspension in saline of the mycelial form (Horse 2), both into the pre-scapular and pre-femoral lymph nodes, with scarification of the skin of the left hind limb, conjunctiva of the right eye and the nasal membrane of the right nostril. The two other horses served as controls. Nodular lesions of EL appeared during the ...
Engelking LR, Anwer MS, Hofmann AF.The role of bile salt in biliary lipid excretion was studied in 3 healthy ponies with chronic external biliary fistulas. After endogenous bile salt pool depletion, micelle-forming taurocholate or taurochenodeoxycholate was infused to replace excreted bile salt. Enterohepatic circulations were held open (total biliary diversion) throughout each study. Results indicated that biliary lipid excretion in ponies (113 +/- 21 nmol/min/kg of body weight) is approximately 10 times less than that reported in rodents. Although the lipid composition (4.4% cholesterol, 5.6% phospholipid, and 90% bile salt) ...
Pezzanite LM, Griffenhagen GM, Krause DM, Hendrickson DA.Prophylactic perioperative antimicrobial protocols in equine synovial endoscopy have been described but not compared with respect to post-operative outcomes and complications. Increasing antimicrobial resistance in equine practice and interest in promoting judicious use of antimicrobials has prompted reevaluation of drug selection and dosing strategies. To determine the frequency of and compare post-operative complications following elective synovial endoscopy between horses receiving different perioperative antimicrobial protocols. Records from the Colorado State University Veterinary Teachin...
Tukia E, Hallman I, Penttilä M, Hänninen S, Kareskoski M.Endometritis is one of the major causes of infertility in mares. and -haemolytic streptococci are among the bacterial species most frequently isolated from the equine uterus. Some bacteria such as -hemolytic streptococci, can persist in dormant forms and cause prolonged, latent or recurrent infections. Dormant bacteria may be present despite negative bacterial cultures, and they are resistant to antimicrobial treatment due to their resting metabolic state. The purpose of this study was to study formalin-fixed paraffin-embedded equine endometrial biopsies for the presence and localization of -...
Traub-Dargatz J, Kopral C, Wagner B.This study is the first report estimating, on a national basis, the use of various biosecurity practices, singly and in combination, on U.S. equine operations. Use of biosecurity practices is described for operations by risk level, based on reported exposure of resident horses to outside horses during the previous 12 months. In addition, the association between use of various biosecurity practices and use of antibiotics to treat infectious disease in both adult equids and foals is reported. The comparison of these study findings with previously reported data in the literature is limited by the...
Lane JG, Gibbs C, Meynink SE, Steele FC.The radiographic procedures used for examination of the facial area and paranasal sinuses of 235 horses are reported. Clinical indications for these examinations and the diagnoses made are reviewed. Unilateral nasal discharge was the commonest reason for radiography, accounting for about one third of cases, most of which had radiological signs of paranasal sinus disease recognisable on erect lateral films. Oblique projections were required to obtain further information about the maxillary dental arcades and ventro-dorsal views demonstrated sinus expansion and extension of disease into the nasa...
