Equine veterinary journal2026; doi: 10.1002/evj.70224

Computed tomography long-term follow-up of a facial fracture involving the orbit and paranasal sinus.

Kalinovskiy, A
·
Lischer, C
·
Eule, JC
·
Thieme, K
·
Mählmann, K

Abstract: Fractures of the facial bones involving the orbit are challenging conditions that require surgical treatment. Objective: To describe preoperative and postoperative clinical and computed tomographic findings of an orbital rim fracture repaired using a reconstruction plate. Methods: Case report. Methods: A 14-year-old Haflinger mare was presented with an open, depressed and comminuted fracture involving the frontal, nasal, lacrimal and maxillary bone, sinus system and the medial aspect of the orbital rim and wall on the right side, as diagnosed by CT. Fracture repair included orbital rim reconstruction with a pre-shaped 12-hole 3.5-mm LCP-reconstruction-plate and repositioning/fixation of several fragments, including one large frontal nasal bone fragment, with cerclage wire sutures. Despite an implant infection postoperatively, the fracture healing assessed by CT 10 weeks later was considered good, and the reconstruction plate was removed at the same time. Results: CT follow-up 1 year after fracture fixation revealed excellent restoration and healing of the orbital rim and wall. Complete resorption of the large repositioned frontal/nasal bone fragment was observed, resulting in a skin-covered bone defect adjacent to the right sinus system. CT imaging also suggested a potential mucocele formation within the right sinus system. Both findings were clinically inapparent and identified solely on CT examination. Conclusions: An excellent long-term outcome was achieved in this orbital fracture repaired with application of a pre-shaped 3.5-mm LCP-reconstruction plate, despite sinus communication, severe comminution and later implant infection, as assessed by CT. In conclusion, CT proved highly valuable for a systematic approach to fracture treatment and perioperative assessment of facial fractures in the present case. Several findings that had not been previously described could be characterised for the first time based on CT assessment. However, the long-term clinical relevance of the described findings needs further evaluation.

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Publication Date: 2026-06-24 PubMed ID: 42340120DOI: 10.1002/evj.70224Google Scholar: Lookup

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Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Overview

This study reports a long-term follow-up using computed tomography (CT) on a complex facial fracture involving the orbital rim and paranasal sinus in a horse, highlighting the surgical repair, healing process, and postoperative complications.
The research emphasizes the use of CT imaging to monitor fracture healing and identify complications not visible through clinical examination alone.

Introduction and Objective

Facial bone fractures involving the orbit are complex injuries often requiring surgical intervention.
The study aimed to describe the clinical and CT findings before and after surgical repair of an orbital rim fracture using a reconstruction plate.
The focus is on evaluating healing and long-term outcomes through imaging.

Case Details and Methods

Subject: A 14-year-old Haflinger mare with multiple fractures in the right facial region, including frontal, nasal, lacrimal, and maxillary bones, affecting the sinus and medial orbital rim and wall.
Diagnosis: CT imaging was used to accurately identify the extent and nature of the fractures.
Surgical intervention involved:

Orbital rim reconstruction using a pre-shaped 12-hole 3.5-mm locking compression plate (LCP) reconstruction plate.
Repositioning and fixation of bone fragments including a large frontal-nasal fragment, secured with cerclage wire sutures.

Postoperative complication: The mare developed an implant infection after surgery.
Follow-up CT scans were taken 10 weeks and 1 year post-surgery to assess healing and complications.

Results

10 weeks post-surgery:

CT showed good fracture healing despite the presence of implant infection.
The reconstruction plate was removed due to the infection.

1 year follow-up CT showed:

Excellent restoration and healing of the orbital rim and orbital wall bones.
Complete resorption of the large repositioned frontal/nasal bone fragment, leaving a bone defect covered by skin adjacent to the sinus.
Possible formation of a mucocele (a mucus-filled cyst) inside the right sinus system, detected only via CT imaging.
Neither the bone defect nor the mucocele caused clinical signs or visible problems in the horse.

Conclusions and Significance

The use of a pre-shaped 3.5-mm LCP reconstruction plate enabled successful long-term healing of a severely comminuted and complicated orbital fracture, even with sinus communication and postoperative infection.
CT imaging proved highly valuable for a systematic approach to treatment and monitoring, enabling detection of subtle or asymptomatic changes that would have otherwise gone unnoticed.
The complete resorption of the large bone fragment and mucocele formation are novel CT findings not previously described in similar cases.
Although these findings were clinically silent in this case, their long-term clinical relevance remains to be fully understood and warrants further research.

Implications for Veterinary Surgery and Imaging

This report highlights the importance of advanced imaging techniques such as CT in managing complex facial fractures, particularly in large animals.
CT allows for detailed visualization of bone healing, implant positioning, and potential complications like infection or mucoceles.
Findings from such imaging can guide clinical decisions including implant removal timing and help predict long-term outcomes.

Cite This Article

APA

Kalinovskiy A, Lischer C, Eule JC, Thieme K, Mählmann K. (2026). Computed tomography long-term follow-up of a facial fracture involving the orbit and paranasal sinus. Equine Vet J. https://doi.org/10.1002/evj.70224

Publication

Equine veterinary journal

ISSN: 2042-3306

NlmUniqueID: 0173320

Country: United States

Language: English

Researcher Affiliations

Kalinovskiy, A

Equine Clinic, Freie Universität Berlin, Berlin, Germany.

Lischer, C

Equine Clinic, Freie Universität Berlin, Berlin, Germany.

Eule, J C

Unit for Ophthalmology, Veterinary Hospital, Freie Universität Berlin, Berlin, Germany.

Thieme, K

Unit for Ophthalmology, Veterinary Hospital, Freie Universität Berlin, Berlin, Germany.

Mählmann, K

Equine Clinic, Freie Universität Berlin, Berlin, Germany.

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