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Topic:Horses

"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.
First Detection and Genetic Characterization of New Equine Parvovirus Species Circulating among Horses in Korea.
Veterinary sciences    November 7, 2021   Volume 8, Issue 11 doi: 10.3390/vetsci8110268
Yoon J, Park T, Kim A, Song H, Park BJ, Ahn HS, Go HJ, Kim DH, Lee JB, Park SY, Song CS, Lee SW, Choi IS.Equine parvovirus-cerebrospinal fluid (EqPV-CSF) and eqcopivirus (EqCoPV) are new parvovirus species (EqPVs) identified from various tissues (CSF, blood, and respiratory swabs) in horses with neurologic and respiratory diseases. In this study, we described the prevalence rate of EqPV-CSF and EqCoPV in 133 and 77 serum and fecal samples, respectively, using polymerase chain reaction. Further, we analyzed the potential risk factors for infection. We calculated the nucleotide and amino acid similarity and constructed phylogenetic trees. There was a moderate-to-high prevalence rate (EqPV-CSF: 3.8%...
Successful application of closed loop stimulation pacemakers with remote monitoring in 3 miniature donkeys with syncope.
Journal of veterinary internal medicine    November 6, 2021   Volume 35, Issue 6 2920-2925 doi: 10.1111/jvim.16305
De Lange L, Van Steenkiste G, Vernemmen I, Vera L, Cromheeke KMC, Walser U, Meert H, Decloedt A, van Loon G.Rate-adaptive single chamber pacemakers with accelerometer, closed loop stimulation (CLS), and remote monitoring functionality (Eluna 8 SR-T, Biotronik, SE & Co, Germany) were implanted in 3 miniature donkeys with third-degree atrioventricular block and syncope. After recovery, different pacemaker programming modes were tested at rest, during stress without physical exercise and during physical exercise. Pacing rates were compared to actual atrial rates and showed that CLS functionality allowed physiological heart rate adaptation. A transmitter installed in the stable provided wireless connect...
Symmetric dimethylarginine concentrations in healthy neonatal foals and mares.
Journal of veterinary internal medicine    November 5, 2021   Volume 35, Issue 6 2891-2896 doi: 10.1111/jvim.16295
Bozorgmanesh R, Thornton J, Snyder J, Fletcher C, Mack R, Coyne M, Murphy R, Hegarty E, Slovis N.Symmetric dimethylarginine (SDMA) is a renal biomarker correlated with glomerular filtration rate (GFR). Objective: Describe changes in SDMA in clinically healthy foals and their mares during the first month postfoaling. Methods: Convenience sampling of healthy periparturient Thoroughbred mares and their full-term foals from a population of client-owned horses. Methods: Serum and EDTA whole blood samples were collected from mares in their last month of pregnancy and then from mares and foals at approximately <12 hours, 48 hours, 7 days, and 30 days postbirth. Samples were processed ...
Ecology and Epidemiology of Eastern Equine Encephalitis Virus in the Northeastern United States: An Historical Perspective.
Journal of medical entomology    November 5, 2021   Volume 59, Issue 1 1-13 doi: 10.1093/jme/tjab077
Armstrong PM, Andreadis TG.In the current review, we examine the regional history, ecology, and epidemiology of eastern equine encephalitis virus (EEEV) to investigate the major drivers of disease outbreaks in the northeastern United States. EEEV was first recognized as a public health threat during an outbreak in eastern Massachusetts in 1938, but historical evidence for equine epizootics date back to the 1800s. Since then, sporadic disease outbreaks have reoccurred in the Northeast with increasing frequency and northward expansion of human cases during the last 20 yr. Culiseta melanura (Coquillett) (Diptera: Culicidae...
Eastern Equine Encephalitis Virus Taxonomy, Genomics, and Evolution.
Journal of medical entomology    November 5, 2021   Volume 59, Issue 1 14-19 doi: 10.1093/jme/tjab079
Ciota AT.Eastern equine encephalitis virus (EEEV; Togaviridae, Alphavirus) is an arthropod-borne virus (arbovirus) primarily maintained in an enzootic cycle between Culiseta melanura (Coquillett) and passerine birds. EEEV, which has the highest reported case- fatality rate among arbovirus in the Americas, is responsible for sporadic outbreaks in the Eastern and Midwest United States. Infection is associated with severe neurologic disease and mortality in horses, humans, and other vertebrate hosts. Here, we review what is known about EEEV taxonomy, functional genomics, and evolution, and identify gaps i...
Randomized, controlled trial comparing Rhodococcus equi and poly-N-acetyl glucosamine hyperimmune plasma to prevent R equi pneumonia in foals.
Journal of veterinary internal medicine    November 5, 2021   Volume 35, Issue 6 2912-2919 doi: 10.1111/jvim.16294
Kahn SK, Cywes-Bentley C, Blodgett GP, Canaday NM, Turner-Garcia CE, Flores-Ahlschwede P, Metcalfe LL, Nevill M, Vinacur M, Sutter PJ, Meyer SC....Hyperimmune plasma raised against β-1→6-poly-N-acetyl glucosamine (PNAG HIP) mediates more opsonophagocytic killing of Rhodococcus equi (R equi) than does R equi hyperimmune plasma (RE HIP) in vitro. The relative efficacy of PNAG HIP and RE HIP to protect foals against R equi pneumonia, however, has not been evaluated. Objective: Transfusion with PNAG HIP will be superior to RE HIP in foals for protection against R equi pneumonia in a randomized, controlled, blinded clinical trial. Methods: Four hundred sixty Quarter Horse and Thoroughbred foals at 5 large breeding farms in the Un...
Multidrug-resistant Serratia rubidaea strains in the oral microbiota of healthy horses.
Open veterinary journal    November 5, 2021   Volume 11, Issue 4 598-602 doi: 10.5455/OVJ.2021.v11.i4.9
da Costa Pimenta J, Saavedra MJ, da Silva GJ, Cotovio M.Many emergent pathogenic agents are cross-transmitted from animals to humans. Horses are considered as potential reservoirs of commensal, zoonotic, and multidrug-resistant bacteria. Equine bites could lead to infections caused by these agents, considering equine species as a public health concern. The more it is known about the equine oral microbiota the best secondary problems created by their commensal flora can be controlled. There are very few reports of , a zoonotic and opportunistic bacterium, both in human and veterinary medicine. Objective: This study aimed to evaluate the Gram-negativ...
Eastern Equine Encephalomyelitis in Michigan: Historical Review of Equine, Human, and Wildlife Involvement, Epidemiology, Vector Associations, and Factors Contributing to Endemicity.
Journal of medical entomology    November 5, 2021   Volume 59, Issue 1 27-40 doi: 10.1093/jme/tjab153
Stobierski MG, Signs K, Dinh E, Cooley TM, Melotti J, Schalow M, Patterson JS, Bolin SR, Walker ED.Eastern equine encephalomyelitis (EEE) is a mosquito-borne viral disease that is an emerging public health concern in the state of Michigan. Although Michigan has one of the highest incidence rates of EEE in the United States, much of the information known about cases in humans, equines, and other animals residing in Michigan is unpublished. This article summarizes such information and explores spatial trends in the historic distribution of EEE in Michigan. Outbreaks in Michigan have occurred over an 80-yr interval, involving only horses in 1942-1943 and 1973-1976, and then episodically from 1...
Inflammatory bowel disease characterized by multisystemic eosinophilic epitheliotropic disease (MEED) in a horse in Saskatchewan, Canada.
The Canadian veterinary journal = La revue veterinaire canadienne    November 4, 2021   Volume 62, Issue 11 1190-1194 
Villagrán CC, Vogt D, Gupta A, Fernández EA.A 3-year-old Quarter Horse gelding was evaluated for chronic weight loss, diarrhea, and pruritus. Physical examination revealed several ulcerative lesions on the skin and mucosal membranes. Diagnostic imaging findings were consistent with enteritis, typhlitis, and colitis. Multisystemic eosinophilic epitheliotropic disease (MEED) was diagnosed upon necropsy. This disease may be considered a form of equine inflammatory bowel disease complex which can be challenging to diagnose, requiring histological assessment, and in some cases, the use of immunohistochemical markers. Key clinical message: Mu...
Relationship between maximum eye temperature and plasma cortisol concentration in racehorses during intensive training.
Polish journal of veterinary sciences    November 4, 2021   Volume 24, Issue 3 393-397 doi: 10.24425/pjvs.2021.138730
Soroko M, Howell K, Dudek K, Waliczek A, Micek P, Flaga J.The aim of the study was to determine the utility of maximum eye temperature measured by infrared thermography (IRT) as a stress indicator compared with plasma cortisol concentration in Thoroughbred and Arabian racehorses. The study included thirty racehorses undergoing standard training for racing. Measurements of maximum eye temperature and blood collection for plasma cortisol concentration were carried out before training (BT), and within 5 (5AT) and 120 minutes (120AT) after the end of the each training session in three repetitions, with a monthly interval. Both parameters were elevated at...
Cervical Epidural Spinal Analgesia for Acute Management of Severe Unilateral Forelimb Lameness: Case Report.
Frontiers in veterinary science    November 4, 2021   Volume 8 749713 doi: 10.3389/fvets.2021.749713
Watkins AR, Hopster K, Levine D, Hurcombe SD.A 20-year-old Quarter Horse gelding was presented with severe right forelimb lameness (5/5 AAEP Lameness Scale) due to a tear of the superficial digital flexor muscle which was diagnosed via palpation of swelling and ultrasonography revealing major muscle fiber disruption and hematoma formation. When traditional systemic therapy (non-Steroidal anti-inflammatories) did not restore clinically acceptable comfort and the risk of supporting limb laminitis became a reasonable concern, a cervical epidural catheter was placed between the first and second cervical vertebrae in the standing, sedated pat...
High prevalence of Mycoplasma equirhinis in Thoroughbred horses with respiratory symptoms in autumn 2018.
The Journal of veterinary medical science    November 4, 2021   Volume 83, Issue 12 1907-1912 doi: 10.1292/jvms.21-0163
Uchida-Fujii E, Kinoshita Y, Niwa H, Maeda T, Nukada T, Ueno T.Mycoplasma species are often isolated from horses with respiratory symptoms; however, the pathogenicity of Mycoplasma is still unclear. In autumn of 2018, we encountered an increase in cases with respiratory symptoms, mainly coughing, in a group of Thoroughbred racehorses in Japan. We examined tracheal wash samples obtained from 40 of those cases. Bacteria and viruses that commonly cause respiratory symptoms were investigated, and anaerobes were detected in only 5 cases and Streptococcus equi subsp. zooepidemicus (S. zooepidemicus) was detected in only 1 case of 40 cases with loop-mediated iso...
Retrospective study of the prevalence of factors contributing to successful standing at first attempt in horses recovering from general anesthesia.
Veterinary anaesthesia and analgesia    November 3, 2021   Volume 49, Issue 1 95-103 doi: 10.1016/j.vaa.2021.10.005
de Miguel Garcia C, Campoy L, Parry SA, Martin-Flores M, Gleed RD.Several factors affect the quality of recovery from general anesthesia in horses. These can increase the likelihood of injury. Body and limb position during recovery may correlate with successful standing. The objective of this study was to identify the prevalence of and the factors associated with successful standing at the first attempt in horses undergoing general anesthesia. Methods: Retrospective study. Methods: Video of recovery and anesthetic records from 221 equine patients were reviewed by six veterinary students. Cases with poor video quality or incomplete anesthetic records were exc...
Computed tomographic myelography for assessment of the cervical spinal cord in ataxic warmblood horses: 26 cases (2015-2017).
Journal of the American Veterinary Medical Association    November 3, 2021   Volume 259, Issue 10 1188-1195 doi: 10.2460/javma.20.11.0614
Rovel T, Zimmerman M, Duchateau L, Adriaensen E, Mariën T, Saunders JH, Vanderperren K.To quantify the degree of dural compression and assess the association between site and direction of compression and articular process (AP) size and degree of dural compression with CT myelography. 26 client-oriented horses with ataxia. Spinal cord-to-dura and AP-to-cross-sectional area of the C6 body ratios (APBRs) were calculated for each noncompressive site and site that had > 50% compression of the subarachnoid space. Site of maximum compression had the largest spinal cord-to-dura ratio. Fisher exact test and linear regression analyses were used to assess the association between site an...
Computed tomographic examination of the articular process joints of the cervical spine in warmblood horses: 86 cases (2015-2017).
Journal of the American Veterinary Medical Association    November 3, 2021   Volume 259, Issue 10 1178-1187 doi: 10.2460/javma.20.03.0105
Rovel T, Zimmerman M, Duchateau L, Delesalle C, Adriaensen E, Mariën T, Saunders JH, Vanderperren K.To describe articular process joints (APJs) of the cervical spine in horses on the basis of CT and to determine whether abnormalities were associated with clinical signs. 86 client-owned warmblood horses. Horses that underwent CT of the cervical spine between January 2015 and January 2017 were eligible for study inclusion. Medical records were reviewed for age, body weight, breed, sex, history, clinical signs, and CT findings. Horses were divided into 3 case groups and 1 control group on the basis of clinical signs. 70 warmblood horses were cases, and 16 were controls. Abnormalities were more ...
Development and preliminary validation of a pain scale for ophthalmic pain in horses: The Equine Ophthalmic Pain Scale (EOPS).
Veterinary journal (London, England : 1997)    November 3, 2021   Volume 278 105774 doi: 10.1016/j.tvjl.2021.105774
Ortolani F, Scilimati N, Gialletti R, Menchetti L, Nannarone S.The purpose of this study was to describe the development and preliminary validation of a composite pain scale, called the Equine Ophthalmic Pain Scale (EOPS), to assess ocular pain in horses. Indicators associated with ocular pain were selected and classified as behavioural, physiological or ocular expressions. Eight horses diagnosed with ocular or adnexa diseases that required medical or surgical treatment were enrolled in the study (group P). The developed EOPS was applied at the baseline (T0) and 1 week later (T7). Moreover, the EOPS was applied twice, 1 week apart, to 15 healthy control h...
An exploration of stakeholder perceptions to inform the development of an evidence-based classification system in para dressage.
Journal of sports sciences    November 2, 2021   Volume 40, Issue 4 459-469 doi: 10.1080/02640414.2021.1997012
St George L, Thetford C, Clayton HM, Hobbs SJ.In dressage, horse-rider combinations must demonstrate harmony whilst performing a test of gaits and movements, scored by judge(s) using predetermined criteria. The para dressage governing body is working towards compliance with the International Paralympic Committee's mandate for evidence-based classification, which requires a comprehensive understanding of key performance determinants. This study aimed to explore stakeholder perceptions surrounding the key determinants of, and impact of impairment on, para dressage performance. Semi-structured interviews with 30 para dressage stakeholders (a...
An Evaluation of Current Preventative Measures Used in Equine Practice to Maintain Distal Forelimb Functionality: A Mini Review.
Frontiers in veterinary science    November 2, 2021   Volume 8 758970 doi: 10.3389/fvets.2021.758970
Clarke EJ, Gillen A, Turlo A, Peffers MJ.Horses are used in a variety of equestrian disciplines predisposing them to musculoskeletal injury or disease including osteoarthritis and tendinopathy. As a result, a number of preventative measures are used within equine medicine and husbandry, ranging from therapeutic shoeing to the use of nutraceuticals. Despite their popularity and routine use evidence base and clinical outcomes are variable, bringing into question the efficacy of these prophylactic measures. In recent years a small number of studies have been performed examining the effect of specific strategies in order to quantify the ...
Investigation of equine testis contribution to vitamin D bioactivation.
Domestic animal endocrinology    November 1, 2021   Volume 79 106691 doi: 10.1016/j.domaniend.2021.106691
Rouge M, Elkhatib R, Delalande C, Cognié J, Reigner F, Barriere P, Deleuze S, Cousty M, Legendre F, Galera P, Hanoux V, Bouraima-Lelong H.Although vitamin D acts in various biological processes, it plays a critical role in the maintenance of bone health, and regulates calcium homeostasis. In humans and rodents, the main tissues involved in vitamin D metabolism are the liver and the kidneys, however it has been shown that the testis has strongly participated in its bioactivation. Indeed, in these different species, enzymes metabolizing vitamin D (CYP27A1, CYP27B1 and CYP2R1) have been demonstrated in this tissue. Moreover, men with hypogonadism have shown a decrease in circulating levels of vitamin D. In equine species, the castr...
Scientists say Australian plan to cull up to 10,000 wild horses doesn’t go far enough.
Nature    November 1, 2021   doi: 10.1038/d41586-021-02977-7
Nogrady B.No abstract available
Macroscopic, Histologic, and Immunomodulatory Response of Limb Wounds Following Intravenous Allogeneic Cord Blood-Derived Multipotent Mesenchymal Stromal Cell Therapy in Horses.
Cells    November 1, 2021   Volume 10, Issue 11 doi: 10.3390/cells10112972
Mund SJK, MacPhee DJ, Campbell J, Honaramooz A, Wobeser B, Barber SM.Limb wounds are common in horses and often develop complications. Intravenous multipotent mesenchymal stromal cell (MSC) therapy is promising but has risks associated with intravenous administration and unknown potential to improve cutaneous wound healing. The objectives were to determine the clinical safety of administering large numbers of allogeneic cord blood-derived MSCs intravenously, and if therapy causes clinically adverse reactions, accelerates wound closure, improves histologic healing, and alters mRNA expression of common wound cytokines. Wounds were created on the metacarpus of 12 ...
Combination of end-to-end jejuno-ileal anastomosis and side-to-side incomplete ileocecal bypass (hybrid jejuno-ileo-cecal anastomosis) following subtotal ileal resection in seven horses.
Journal of the American Veterinary Medical Association    November 1, 2021   Volume 259, Issue 11 1337-1343 doi: 10.2460/javma.20.10.0577
Gandini M, Giusto G.7 horses (3 geldings, 2 mares, and 2 stallions) were examined because of acute colic caused by small intestinal obstruction involving the aborad portion of the jejunum and orad portion of the ileum. All horses underwent a routine colic examination on arrival and had a diagnosis of strangulating obstruction of the small intestine. All horses underwent emergency exploratory laparotomy, in which the affected aborad portion of the jejunum and orad portion of the ileum were resected; in 5 horses, a hand-sewn end-to-end jejuno-ileal anastomosis was combined with a hand-sewn incomplete ileocecal bypa...
Genetic inbreeding depression load for fertility traits in Pura Raza Española mares.
Journal of animal science    November 1, 2021   Volume 99, Issue 12 skab316 doi: 10.1093/jas/skab316
Perdomo-González DI, Molina A, Sánchez-Guerrero MJ, Bartolomé E, Varona L, Valera M.Fertility is a key factor in the economic success of horse farms. However, it has received little attention due to the difficulty of measuring fertility objectively. Since its studbook creation (1912), the Pura Raza Española (PRE) breed has been a closed population and become high in-bred resulting in inbreeding depression (poor phenotypic values). Nevertheless, heterogeneous effects of inbreeding depression have been detected among founders and nonfounders. The aims of this study were (1) to analyze the genetic parameters for reproductive traits in mares of the PRE horse breed and (2) to est...
Comparison of image quality of corneal and retinal optical coherence tomography using sedation and general anesthesia protocols with or without retrobulbar anesthesia in horses.
American journal of veterinary research    November 1, 2021   Volume 83, Issue 1 72-79 doi: 10.2460/ajvr.21.02.0029
Hefner EM, Lin HC, Cole RC, Moore PA, McMullen RJ.To compare image quality and acquisition time of corneal and retinal spectral domain optical coherence tomography (SD-OCT) under 3 different sedation-anesthesia conditions in horses. Methods: 6 middle-aged geldings free of ocular disease. Methods: 1 randomly selected eye of each horse was evaluated via SD-OCT under the following 3 conditions: standing sedation without retrobulbar anesthetic block (RB), standing sedation with RB, and general anesthesia with RB. Five regions of interest were evaluated in the cornea (axial and 12, 3, 6, and 9 o'clock positions) and fundus (optic nerve head). Thre...
Corrigendum: Evidence in Practice – a Pilot Study Leveraging Companion Animal and Equine Health Data From Primary Care Veterinary Clinics in New Zealand.
Frontiers in veterinary science    November 1, 2021   Volume 8 789718 doi: 10.3389/fvets.2021.789718
Muellner P, Muellner U, Gates MC, Pearce T, Ahlstrom C, O'Neill D, Brodbelt D, Cave NJ.[This corrects the article DOI: 10.3389/fvets.2016.00116.].
Gross, computed tomographic, and endoscopic anatomy of the equine carpal extensor tendon sheaths.
Veterinary surgery : VS    November 1, 2021   Volume 51, Issue 1 202-213 doi: 10.1111/vsu.13743
Baldwin CM, Morgan RE, Crawford AL, Villarino NF, Rubio-Martínez LM.(1) To describe the computed tomography (CT) and gross anatomy of the equine extensor carpi radialis sheath (ECRS) and common digital extensor sheath (CDETS); (2) to describe a single-portal endoscopic examination of the ECRS and CDETS. Methods: Ex vivo experimental. Methods: Thirty clinically normal cadaver thoracic equine limbs severed at the humeral diaphysis. Methods: Ten limbs underwent plain and intrathecal contrast CT examinations and gross dissection of the ECRS and CDETS. Single-portal endoscopic examination of ECRS and CDETS was attempted in 4 limbs and endoscopic examination was per...
Effect of omeprazole and sucralfate on gastrointestinal injury in a fasting/NSAID model.
Equine veterinary journal    October 31, 2021   doi: 10.1111/evj.13534
Bishop RC, Kemper AM, Wilkins PA, McCoy AM.Equine gastric ulcer syndrome (EGUS) is a common and significant cause of morbidity in horses, with a range of clinical signs, including inappetence, colic and poor performance. Hospitalised horses are exposed to factors that may induce EGUS, including fasting and nonsteroidal anti-inflammatory drug (NSAID) administration, and may be at risk for development of squamous (ESGD) and glandular gastric disease (EGGD). Prophylactic anti-ulcer medication is often prescribed for these patients, but drug selection is complicated by different aetiology and response to treatment of ESGD and EGGD. Objecti...
Rapid Detection of Equine Piroplasms Using Multiplex PCR and First Genetic Characterization of Theileria haneyi in Egypt.
Pathogens (Basel, Switzerland)    October 31, 2021   Volume 10, Issue 11 1414 doi: 10.3390/pathogens10111414
Elsawy BSM, Nassar AM, Alzan HF, Bhoora RV, Ozubek S, Mahmoud MS, Kandil OM, Mahdy OA.Equine Piroplasmosis (EP) is an infectious disease caused by the hemoprotozoan parasites , , and the recently identified species . Hereby, we used a multiplex PCR (mPCR) targeting the 18S rRNA gene of and for the simultaneous detection of EP in Egyptian equids and examined the presence of infections in Egypt. Blood samples from 155 equids (79 horses and 76 donkeys) collected from different governorates of Egypt were examined by mPCR and PCR targeting . The mPCR method revealed a prevalence of of 20.3% in horses and of 13.1% in donkeys and a prevalence of . of 1.2% in horses. . was not de...
A Questionnaire Study on the Use of Complementary and Alternative Veterinary Medicine for Horses in Sweden.
Animals : an open access journal from MDPI    October 30, 2021   Volume 11, Issue 11 doi: 10.3390/ani11113113
Gilberg K, Bergh A, Sternberg-Lewerin S.Complementary or alternative veterinary medicine (CAVM) includes treatment methods with limited scientific evidence. Swedish veterinarians are legally obliged to base treatments and recommendations on science or well-documented experience, but most CAVM methods are not well documented in animals. The aim of this study was to explore the use of CAVM in Swedish horses. Electronic questionnaires were distributed to horse owners, equine veterinary practitioners and CAVM therapists. Of the 204 responding horse owners, 83% contacted a veterinarian first in case of lameness, while 15% contacted a CAV...
The facultative human oral pathogen Prevotella histicola in equine cheek tooth apical/ periapical infection: a case report.
BMC veterinary research    October 30, 2021   Volume 17, Issue 1 343 doi: 10.1186/s12917-021-03048-9
Kau S, Mansfeld MD, Šoba A, Zwick T, Staszyk C.Prevotella histicola is a facultative oral pathogen that under certain conditions causes pathologies such as caries and periodontitis in humans. Prevotella spp. also colonize the oral cavity of horses and can cause disease, but P. histicola has not yet been identified. Methods: A 12-year-old Tinker mare was referred to the clinic for persistent, malodorous purulent nasal discharge and quidding. Conservative antibiotic (penicillin), antiphlogistic (meloxicam), and mucolytic (dembrexine-hydrochloride) treatment prior to referral was unsuccessful and symptoms worsened. Oral examination, radiograp...