"Horses" is a broad topic that encompasses various aspects of equine biology, behavior, and management. This category includes studies on the anatomy, physiology, and genetics of horses, as well as their behavior, nutrition, and care. Research in this area may also cover the historical and cultural significance of horses, their roles in agriculture, sport, and therapy, and the challenges associated with their conservation and welfare. The page aggregates peer-reviewed research articles and scholarly studies that explore the multifaceted relationships between humans and horses, examining both scientific and socio-economic perspectives.
Young DR, Nunamaker DM, Markel MD.Eight untrained 2-year-old Thoroughbred horses were used in a study of the remodeling response of the proximal sesamoid bone (PSB) to training-related stimuli. Two horses each were assigned to 1 of 4 groups: group 1, untrained, pasture turnout (control); group 2, modified-classically trained, dirt track; group 3, classically trained, dirt track; and group 4, classically trained, wood chip track. Horses were given fluorochromic bone labels every 28 days during training. All horses were euthanatized after 5 months of training, and the proximal sesamoid bones (PSB) were removed. A midsagittal sec...
Watson TD, Sullivan M.The effects of sedation with detomidine on oesophageal function were assessed by contrast radiography in 10 healthy adult thoroughbred horses. Barium swallows were monitored by means of image intensification, first without sedation and then after the intravenous administration of detomidine at doses of 10 and 20 micrograms/kg bodyweight. The transit time of contrast agent to the oesophageal hiatus was recorded and each swallow was scored for markers of oesophageal dysfunction. Analysis of the data indicated that there were highly significant dose dependent increases in the transit time, the re...
Science (New York, N.Y.)July 19, 1991
Volume 253, Issue 5017 306-308 doi: 10.1126/science.1857965
Farley CT, Taylor CR.It is widely thought that animals switch gaits at speeds that minimize energetic cost. Horses naturally switched from a trot to a gallop at a speed where galloping required more energy than trotting, and thus, the gait transition actually increased the energetic cost of running. However, by galloping at this speed, the peak forces on the muscles, tendons, and bones, and presumably the chance of injury, are reduced. When the horses carried weights, they switched from a trot to a gallop at a lower speed but at the same critical level of force. These findings suggest that the trot-gallop transiti...
Charlton C, Tulleners E.Two male racehorses (1 Standardbred, 1 Thoroughbred) were examined because of intraluminal cervical tracheal lesions, located 60 to 70 cm from the nares. A contact neodymium:yttrium aluminum garnet laser with a chisel probe attached to the fiber end was used to transendoscopically debride a nonhealing tracheal ulcer and to excise a pyogranulomatous mass. In both horses, the surgical sites healed quickly and the lesions did not redevelop.
Hoskinson JJ, Wooten P, Evans R.Nonsurgical, percutaneous, transvenous removal of a catheter fragment embolus was performed in a 14-day-old Thoroughbred foal. A basket retrieval catheter was introduced into the jugular vein and manipulated under fluoroscopic guidance to remove the fragment from the right side of the heart. Percutaneous retrieval should be considered as an alternative to thoracotomy for retrieval of intracardiac or intravascular foreign bodies.
Sivula NJ.Between 1984 and 1989, 33 horses were diagnosed with renosplenic entrapment of the large colon. Duration of colic, signalment, physical findings, and laboratory values were determined, and treatment methods were evaluated. Nonsurgical correction was attempted in 22 of the horses with suspected renosplenic entrapment of the large colon and was successful in 11 cases. Survival and complication rates also were determined. Nonsurgical correction is a viable alternative to immediate surgery for renosplenic entrapment of the large colon, if cases are selected properly.
Knowles DP, Perryman LE, Goff WL, Miller CD, Harrington RD, Gorham JR.Babesiosis is a tick-borne hemoparasitic disease affecting horses worldwide. To investigate mechanisms of immunity to this parasite, the antibody response of infected horses to Babesia equi merozoite proteins was evaluated. Immunoprecipitation of B. equi merozoite antigens with sera from infected horses revealed 11 major proteins of 210, 144, 108, 88, 70, 56, 44, 36, 34, 28, and 25 kDa. Monoclonal antibody (MAb) 36/133.97, which binds to live merozoites, immunoprecipitated proteins of 44, 36, 34, and 28 kDa. When immunoprecipitations were performed with in vitro translation products of merozoi...
Reimers TJ, Lamb SV, Bartlett SA, Matamoros RA, Cowan RG, Engle JS.Veterinary diagnostic endocrinology laboratories frequently receive hemolyzed plasma, serum, or blood samples for hormone analyses. However, except for the previously reported harm done by hemolysis to canine insulin, effects of hemolysis on quantification of other clinically important hormones are unknown. Therefore, these studies were designed to evaluate effects of hemolysis on radioimmunoassay of thyroxine, 3,5,3'-triiodothyronine, progesterone, testosterone, estradiol, cortisol, and insulin in equine, bovine, and canine plasma. In the first experiment, hormones were measured in plasma obt...
Jablonska EM, Ziolkowska SM, Gill J, Szykula R, Faff J.Effects of an 18 min exercise test, on three separate occasions during a one year jump-training programme, was studied in seven horses. Determinations were carried out on venous blood for packed cell volume, haemoglobin, total protein, lactate and pyruvate, glucose, free fatty acids, insulin, glucagon, blood gases, bicarbonate, pH, aldolase, aspartate aminotransferase and alanine amino-transferase. Exercise caused a slight increase in lactate and pyruvate, total protein, aldolase, alanine aminotransferase, pO2, bicarbonate and pH. Glucose, free fatty acids and pCO2 levels decreased. Training c...
Smyth GB.A 4-year-old Quarter horse gelding presented with a swelling in the soft tissues over the junction of the body and ramus of the left mandible. Radiography showed a well circumscribed lytic area within the mandible surrounded by sclerosis unassociated with any tooth. Aspiration of the lesion yielded pus. The abscess cavity was opened, curetted and lavaged. A Penrose drain was placed in the abscess cavity for 10 days. Bacteriological culture of the exudate and soft tissues from the abscess produced a few colonies of Staphylococcus intermedius. Histopathology showed chronic pyogenic infection. Th...
Pinaud MA, Roser JF, Dybdal N.In vitro responsiveness of the horse anterior pituitary (AP) gonadotropes to single and multiple GnRH challenges was examined. The pituitaries were collected from reproductively sound mares in estrus (n = 5) and diestrus (n = 5). Uniform 0.5 mm AP slices were subdivided using a 3 mm biopsy punch and then bisected for use in the perifusion chamber. Four bisected sections per chamber were perifused at 0.5 ml/min at 37 C for 560 min in Medium 199 saturated with 95% 0(2)/5% CO2. Ten minute fractions were collected after an initial 2 hr equilibration period. Four different treatment regimes of GnRH...
Matthews NS, Hartsfield SM, Cornick JL, Williams JD, Beasley A.Six combinations of injectable anesthetic agents were administered to six adult horses in a Latin square design. The drug combinations were xylazine-ketamine, xylazine-butorphanol-ketamine, xylazine-tiletamine-zolazepam, xylazine-butorphanol-tiletamine-zolazepam, detomidine-ketamine, and detomidine-butorphanol-ketamine. Measured variables were heart rate, respiratory rate, systolic blood pressure, arterial pH (pHa), PaCO2, PaO2, recumbency time, and number of attempts necessary to stand. Quality of induction and recovery, muscle relaxation, and response to stimulus were evaluated subjectively....
Watson ED, Zanecosky HG.Immunosuppressive substances which interfere with lymphocyte blastogenesis are released in vitro by embryos and endometrium from mares in early pregnancy. Immunosuppression was not evident when tissues were cultured in the presence of indomethacin (a prostaglandin-synthesis inhibitor). Various prostaglandins (PGs) were added to equine lymphocytes and lymphocyte proliferation was measured after the addition of concanavalin A (Con A) or phytohaemagglutinin A (PHA). PGE2 and PGF2 alpha inhibited Con A-induced blastogenesis down to final concentrations of 1.8 x 10(-9) M and 1.3 x 10(-6) M, respect...
Van Oirschot JT, Bruin G, de Boer-Luytze E, Smolders G.Foals that were born to mares vaccinated twice a year against influenza had moderate to high haemagglutination-inhibition antibody titers at 24 hours after birth. The foals were vaccinated at six and ten weeks of age, and again at three to five months after birth. Four months after the third vaccination no antibodies against A/H7N7 and A/H3N8 influenza viruses were detected in these foals. Thus, maternal antibodies probably prevented the development of antibodies against equine influenza virus after vaccination. Foals born to the same mares one year later were monitored to determine the rate o...
Boosman R, Németh F, Gruys E.This review deals with the features of clinical and subclinical laminitis in cattle. Prominent clinical signs of acute laminitis are a tender gait and arched back. The sole horn reveals red and yellowish discolourations within five days. In subacute and chronic cases clinical signs are less severe. In chronic laminitis the shape of the claws is altered. Laminitis is frequently followed by sole ulceration and white zone lesions. Blood tests showed no significant changes for laminitic animals. Arteriographic studies of claws affected by laminitis indicated that blood vessels had narrowed lumens....
Rose PL, Schumacher J, Taylor TS.An extensive stricture of the left dorsal colon in a Thoroughbred colt was resected and the colon was anastomosed. In two horses, circumferential strictures at the pelvic flexure 2.5 to 3 cm long were corrected with a modified Heineke-Mikulicz pyloroplasty technique. The horses were reported to be doing well at 6, 8, and 45 months, respectively.
Burns GA, Cummings JF.Sellers et al. (1979, Am. J. Phys., 237: E457-E464) proposed a pelvic flexure pacemaker mechanism to account for the bidirectional contraction waves needed to both retain ingesta within the right ventral colon for cellulose digestion and terminal fermentation and to transport the digesta distad once the process has been completed. To corroborate the presence of a pelvic flexure pacemaker, we prepared whole mount samples of the tunica muscularis from 23 horses at ten sites along the large colon, cecum and jejunum. Following smooth muscle enzymatic digestion, somata of the myenteric plexus were ...
LeBlanc PH, Broadstone RV, Derksen FJ, Robinson NE.Distal airway segments (ID, 3 to 4 mm; length, 5 mm) from 2 groups of horses were isolated and suspended in tissue baths filled with Krebs solution, aerated with 5% CO2 in oxygen and maintained at 37 degrees C. Responses to exogenous acetylcholine, isoproterenol, or electrical field stimulation were compared. Control horses (n = 30) had no history of recurrent airway obstruction, whereas principal horses (n = 15) had recurrent airway obstruction and were studied during an acute episode of airway obstruction. Although the distal airways contracted in response to the cumulative half-logarithmic ...
Halldórsdóttir S, Lazary S, Gunnarsson E, Larsen HJ.Three hundred and three horses, exported from Iceland to Norway, Sweden, Denmark, Switzerland or Germany were tested for their distribution of leucocyte antigens. One hundred and thirty-six horses were affected with summer eczema. The panel of sera recognised the internationally accepted ELA-specificities A 1 to A10, and the nine work shop specificities W 11 to W 15 and W 18 to W 21. Also, some local specificities, characterised in Switzerland (Be I, Be III, Be 8, Be 25, Be 26, Be 27), and two non major histocompatibility complex (MHC)-linked antigens (Ely 1:1, Ely 2) were included. Only one a...
Björnstig U, Eriksson A, Ornehult L.Injuries caused by animals and treated at the University Hospital of Umeå were analysed. Dogs caused nearly one-half of the injuries, while horses caused one-third of the injuries and the highest number of fractures. The 'cost' of treatment and sickness benefit was fairly evenly distributed between horse-, cattle-, and dog-related injuries. The average 'cost' per injured person was, however, highest in those injured in cattle accidents and moose-car collisions. The impact of animal-related injuries on the health care and social security systems was similar to occupational accidents and car ac...
Alwan WH, Carter SD, Dixon JB, Bennett D, May SA, Edwards GB.Synovial fluid samples of horses with osteoarthritis were investigated to detect interleukin-1 (IL-1) activity which could contribute to the disease pathogenesis. Of the 32 samples tested, 12 (37.5 per cent) showed an augmented phytohaemagglutinin induced proliferation of C3H/HeJ mouse thymocytes. Positive results were also seen in horses with infected arthritis, osteochondritis, traumatic arthritis and undefined synovial effusions. Normal synovial fluid and sera from all groups failed to show any detectable IL-1 activity. Fractionation of synovial fluid showed that the IL-1 activity was in th...
Hatzipanagiotou A, Lindner A, Sommer H.The distribution of LDH and CK isoenzymes in blood plasma of ten clinically sound Thoroughbreds with reasonable performance and without elevated clinico-chemical blood variables (reference group) was compared with 57 Thoroughbreds, which had histories of mild locomotor disturbances and/or poor performance and had elevated CK, LDH and/or AST activities (trial group). The trial group was subdivided according to the number of altered blood variables and in the groups with two as well as three altered blood variables also according to the extent of alteration of the total CK activity. The pattern ...
Stewart DR, Nevins B, Hadas E, Vandlen R.Relaxin, a polypeptide hormone normally associated with pregnancy, has been purified from many species, and the sequence determined for a growing number. Equine relaxin has been previously purified by acetone extraction, gel filtration, and ion exchange chromatographies. In an attempt to develop a more rapid and efficient method for relaxin purification, the use of affinity chromatography coupled with HPLC was explored. Monoclonal antibodies were raised against highly purified equine relaxin; large quantities of antibody were obtained by ascites production and attached to a solid phase support...
Gould JC, Rossano MG, Lawrence LM, Burk SV, Ennis RB, Lyons ET.Parascaris equorum generally infects horses less than 18 months old and its pathological effects can be severe. Infection occurs when larvated eggs, present in pastures, paddocks, stalls, and on feeding and watering equipment are ingested. The purpose of this study was to examine the effects of windrow composting on the viability of P. equorum eggs at a cooperating central Kentucky horse farm. Three grams of feces containing 2216 P. equorum eggs per gram were sealed in filter bag sentinel chambers. Chambers were exposed to 1 of 3 treatments: constant exposure or intermittent exposure to the in...
Reed RA, Knych HK, Barletta M, Sakai DM, Ruch MM, Smyth CA, Ryan CA.To compare the pharmacokinetics and pharmacodynamics of hydromorphone in horses after intravenous (IV) and intramuscular (IM) administration. Methods: Randomized, masked, crossover design. Methods: A total of six adult horses weighing [mean ± standard deviation (SD))] 447 ± 61 kg. Methods: Horses were administered three treatments with a 7 day washout. Treatments were hydromorphone 0.04 mg kg IV with saline administered IM (H-IV), hydromorphone 0.04 mg kg IM with saline IV (H-IM), or saline IV and IM (P). Blood was collected for hydromorphone plasma concentration at multiple time points for ...
Martinez de Andino EV, Brom-de-Luna JG, Canesin HS, Rader K, Resende HL, Ripley AM, Love CC, Hinrichs K.To assess meiotic and developmental competence after transfer of immature cumulus-oocyte complexes (COCs) to the preovulatory follicles of mares (intrafollicular oocyte transfer (IFOT)). Methods: In Experiment 1, mares received an ovulatory stimulus at IFOT. Thirty hours later, COCs were recovered from the follicle, and mature oocytes underwent ICSI and embryo culture. In Experiments 2 and 3, autologous vs. allogeneic COCs were used. The mares were inseminated and embryos were recovered. In Experiment 3, the ovulatory stimulus was administered 9 h (autologous) and 15 h (allogeneic) before IF...
Mayhew IG.Parameters for the accuracy of clinical diagnosis of neurologic diseases in the horse were determined from 210 horses in which a definitive pathologic diagnosis was confirmed. The overall efficiency of diagnosis for all diseases was 0.95 although the validity varied from 0.79 to 1.00, the sensitivity varied from 0.73 to 0.95, and the specificity varied from 0.88 to 1.00 for individual disease categories. Equine protozoal myeloencephalitis was overdiagnosed, whereas Eastern equine encephalomyelitis, equine degenerative myeloencephalopathy, and traumatic neurologic disease were underdiagnosed. T...
Dyer RM, Leid RW.Isolated equine alveolar macrophages obtained by bronchopulmonary lavage of four live ponies demonstrated surface receptors for equine IgG, equine IgM, and complement-coated sheep red blood cells, but not equine IgM or complement-coated erythrocytes alone. In addition, demonstration of IgG receptors was found to depend on the level of erythrocyte sensitization and could not be demonstrated by red blood cell rosetting techniques at low levels of sensitization. Demonstration of receptors for equine complement by red cell rosetting techniques required the presence of both IgM antibody and serum d...
Wilson DV, McFeely AM.Positive end-expiratory pressure (PEEP) was applied in 74 anesthetized, ventilated horses during colic surgery, to attempt to increase arterial oxygen tensions. In 28 horses with an initial PaO2 less than 70 mm of Hg, PEEP increased PaO2 values to a mean of 173 +/- 24 mm of Hg. Arterial oxygen content increased from 14.1 +/- 0.05 ml/dl to 17.2 +/- 0.05 ml/dl. In the remaining 46 horses, PEEP increased PaO2 from a mean value of 101 +/- 6 mm of Hg to 194 +/- 15 mm of Hg, and arterial oxygen content increased from 14.9 +/- 0.09 ml/dl to 16.9 +/- 0.07 ml/dl. Cardiovascular depression and decrease ...
Cook AG, Maxwell VB, Donaldson LL, Parker NA, Ward DL, Morrow JK.To determine whether antibodies against Sarcocystis neurona could be detected in CSF from clinically normal neonatal (2 to 7 days old) and young (2 to 3 months old) foals. Methods: Prospective study. Methods: 15 clinically normal neonatal Thoroughbred foals. Methods: Serum and CSF samples were obtained from foals at 2 to 7 days of age and tested for antibodies against S. neurona by means of western blotting. Serum samples from the mares were also tested for antibodies against S. neurona. Additional CSF and blood samples were obtained from 5 foals between 13 and 41 days after birth and between ...
Mahne AT, Janse van Rensburg D, Hewetson M.A 4-year-old Thoroughbred gelding underwent an explorative celiotomy for a suspected small intestinal obstruction. During surgery, an impacted diverticulum of the ileum was suspected, necessitating a jejunocaecostomy. The owner opted for euthanasia. On post-mortem examination and histopathology, a true diverticulum on the mesenteric side of the ileum, with ileal hypertrophy, was diagnosed.
Allnoch L, Peters M, Wiemer F, Wohlsein P.Severe bilateral mydriasis and bilaterally decreased vision were observed in a 23-year-old crossbred warmblood gelding with a history of pituitary pars intermedia dysfunction. Ten years after the onset of clinical signs, it was killed humanely because of worsening of clinical signs and loss of therapeutic responsiveness. Postmortem examination of the head was performed to confirm the suspected pituitary neoplasm and to investigate secondary oculomotor lesions. Pathomorphologic examination revealed an expansile space-occupying pituitary adenoma and degenerative changes in the preganglionic ocul...
Dunkel B, Rickards KJ, Werling D, Page CP, Cunningham FM.To determine whether expression of equine platelet activation-dependent surface markers is influenced by phospodiesterase (PDE) isoenzyme activity and whether antigen challenge alters platelet PDE activity in horses with recurrent airway obstruction (RAO). Methods: 16 horses. Methods: 7 healthy horses were used for in vitro experiments, 6 horses with RAO were used for antigen challenge, and 6 healthy horses were used as control animals. Three of the healthy horses had also been used in the in vitro experiments. Effects of PDE inhibition and activation of adenylyl cyclase on CD41/61 and CD62P e...
Grelck H, Hörchner F, Wöhrl H.Ten pony foals were infected with Fasciola hepatica; five animals received up to 1000 metacercariae orally, the remaining animals received up to 80 specimens of 24 hours old adulescariae intraperitoneally. The rate of development of the parasites varied in a wide range between 0,2 and 41%. Most of the liverflukes were found in animals severely infected with strongyles in the same time. Only 22 weeks after oral infection, the flukes had reached a length of 20 mm and sexual maturity. Fasciola-eggs could not be detected in the feces.
Luna SP, Taylor PM, Massone F.Six Welsh gelding ponies were premedicated with 0.03 mg/kg of acepromazine intravenously (i.v.) prior to induction of anaesthesia with midazolam at 0.2 mg/kg and ketamine at 2 mg/kg i.v.. Anaesthesia was maintained for 2 h using 1.2% halothane concentration in oxygen. Heart rate, electrocardiograph (ECG), arterial blood pressure, respiratory rate, blood gases, temperature, haematocrit, plasma arginine vasopressin (AVP), dynorphin, beta-endorphin, adrenocorticotropic hormone (ACTH), cortisol, dopamine, noradrenaline, adrenaline, glucose and lactate concentrations were measured before and after ...
The Journal of heredityJuly 1, 1987
Volume 78, Issue 4 248-250 doi: 10.1093/oxfordjournals.jhered.a110376
Bowling AT.Blood type analysis of 29 foals in a paternal half-sib family verified linkage of five LGII loci (Es, E, To, Gc, Al). Population and parentage data from other tobiano-spotted horses suggested conservation of a tightly linked (To:GcS:AlB) marker complex.
Smith SE, Devine DV.To determine the feasibility of hand-assisted laparoscopic ovariectomy via colpotomy for bilateral ovariectomy in standing mares. Methods: Case series. Methods: Mares (n = 21) aged 2-21 years, weighing 312-582 kg. Methods: After a pilot study in 6 mares, the technique was used in 15 mares. Ovaries were identified and manipulated using 2 laparoscopic portals in the left paralumbar fossa. Transection and hemostasis of the ovarian pedicle was achieved using a LigaSure Atlas™ or chain écraseur. Ovaries were removed through a colpotomy by an assistant. Results: In 19 mares, both ovaries were suc...
Gandini M, Giusto G, Iotti B, Valazza A, Sammartano F.Stapled jejunocecal anastomoses are commonly performed in equine abdominal surgery. They carry higher complication rates compared to handsewn techniques. In human surgery various causes likely to lead to failure of stapled techniques have been evaluated, including staple line failure. Recently Freeman proposed a technique to perform a stapled jejunocecal anastomosis in horses while avoiding blind pouch formation. The aim of this study is to describe a method for stapled side-to-side jejunocecal anastomosis in horses and to compare it with other techniques with computed tomography to assess sto...
Hofferer S, Lecompte F, Magallon T, Palmer E, Combarnous Y.Pharmacological control of reproduction in mares requires the use of equine gonadotrophins to avoid induced immunological resistance. Crude equine gonadotrophins (CEG) have been used but the presence of equine luteinizing hormone (eLH) and follicle-stimulating hormone (eFSH) in CEG has led to disappointing results in superovulation studies. Separation of eLH and eFSH activities from CEG is necessary to overcome this problem. The hydrophobic properties of the two hormones were sufficiently different to permit their separation by hydrophobic interaction chromatography (HIC) on a phenyl Sepharose...
Sheoran AS, Nally JE, Donahue JM, Smith BJ, Timoney JF.Leptospira-specific antibody isotypes in sera of late term equine fetuses aborted due to Leptospira interrogans serovar pomona-type kennewicki infection were characterized and compared with those of their dams. IgM was the dominant Leptospira-Specific isotype in both fetuses and mares. However, IgGa was the isotype in highest concentration in petal sera and strong Leptospira-specific IgGa but no IgGb and little or no IgG(T) were detected. In contrast, although IgGb was quantitatively the dominant isotype in mares serum, Leptospira-specific serum IgG in aborting mares was dominated by IgG(T) bu...
Deem DA, Traver DS, Thacker HL, Perryman LE.Immunologic deficiency was suspected in an 18-month-old Standardbred horse with persistent fever, multifocal bacterial infection, and neutropenia with a large number of immature neutrophils. Serum protein electrophoresis revealed marked depression of the gamma-globulin fraction (0.2 g/100 ml). Immunologic testing and histologic examination of lymphoid tissues identified the immune deficit as agammaglobulinemia. Serum concentrations of immunoglobulin (Ig)G and IgG(T) were initially low and declined with time; IgM and IgA were not detectable. The horse failed to produce antibodies when inoculate...
Kasman LH, Hughes JP, Stabenfeldt GH, Starr MD, Lasley BL.Serum and urinary estrone sulfate concentrations were determined in 7 pregnant mares before and after prostaglandin-induced abortion (n = 4) or surgical removal of the fetus (n = 3) to determine the source of estrogen during early pregnancy (gestation days [GD] 44 to 89). Estrone sulfate concentrations also were determined in serum samples (stored frozen for 2 years) from 3 mares that had been ovariectomized between GD 51 and 58. Estrone sulfate concentrations decreased in serum and urine after expulsion or removal of the fetus (urinary patterns were more definitive than were patterns for seru...
Cannon JH, Grant BD, Sande RD.Development of cysts in the equine paranasal sinuses is probably a congenital disease; however, signs may not appear for several years. In 4 cases, clinical signs were observed when fluid accumulation within the cysts resulted in nasal discharge or facial swelling, or when secondary infection occurred. Treatment required surgical removal of the lining membrane and other involved tissues. Postoperative care included lavage of the sinuses and systemic antibiotic therapy.