Empyema of the nasal conchal bulla as a cause of chronic unilateral nasal discharge in the horse: 10 cases (2013-2014).

This research identifies empyema of the nasal conchal bullae as a possible cause behind chronic unilateral nasal discharge in horses. It provides an analysis of the diagnosis and treatment of 10 documented cases, exploring the unseen complexity of equine nasal diseases and proposing that nasal conchal bulla disease be considered in diagnostic procedures.

Background and Objective

• The researchers recognize the recent identification of empyema of the nasal conchal bullae—a condition that involves a collection of pus in these nasal cavities—in horses suffering from chronic unilateral nasal discharge. They propose that the diagnosis and treatment of these cases had previously been unreported.
• The objective of this study is to present these diagnoses and corresponding treatments of cases with empyema of the nasal conchal bullae. It also aims to showcase the frequency of this diagnosis among horses referred for head computed tomography (CT).

Methods and Results

• A retrospective case review was performed, examining records from horses diagnosed with nasal conchal bulla disease using CT scans.
• Out of 102 such examinations, afflictions of the nasal conchal bullae were identified in 10 cases. Eight featured complications in the ventral conchal bulla, while two involved the dorsal conchal bulla.
• Eight of these cases were treated at the study’s clinic—seven of them had an accompanying paranasal sinus disease. Furthermore, a surgical procedure, fenestration, was performed on three horses to drain and clear the empyema in the ventral conchal bulla.

Conclusion and Significance

• The findings from this study suggest that sickness of the conchal bullae should be considered a plausible cause of chronic unilateral nasal discharge in horses.
• The researchers posit that the pus in these bullae (empyema) is unlikely to be cleared solely by washing out the paranasal sinuses, indicating that the issue possibly requires a more comprehensive treatment approach.
• When necessary, they recommend fenestration of the conchal bulla to physically remove the infection. This establishes a new treatment methodology in cases where the horse suffers from chronic nasal discharge tied to empyema of the nasal conchal bullae.