Radiographic identification of the equine ventral conchal bulla.

The study aims to ascertain whether the ventral conchal bulla (VCB), a part of the horse’s sinus structure, can be systematically identified in plain radiographs of healthy horse skulls. The results of the research indicated that the VCB was more likely to be accurately identified if clinicians felt confident in their identification skills.

Objective of the Study

• The main goal of this research was to determine if the ventral conchal bulla (VCB), a part of the horse’s sinus structure, can be clearly identified in radiographs (x-ray images) of horse skulls without any sinus disease.
• This determination is crucial due to the VCB’s significant diagnostic and prognostic value in evaluating equine sinus diseases.

Methodology

• A total of 10 equine skull cadavers were used in this study. These skulls were subjected to bilateral frontonasal sinus flaps.
• Three types of radiographs were taken: lateral, lateral oblique, and dorso-ventral.
• For better visibility and clarity, the same set of images was taken again, this time with a stainless-steel wire outlining the caudal border of the VCB.
• Two observers then independently and blindly evaluated the plain radiographs, indicating where they thought the VCB was located. The results were later cross-referenced with the marked radiographs for accuracy.

Findings

• The VCB was identified correctly in 70% of lateral radiographs, 45% of lateral oblique radiographs, and a mere 17% in dorso-ventral radiographs. This implies that the type of radiograph view significantly influences the successful identification of the VCB.
• This study found a correlation between a clinician’s confidence and accuracy. When the clinicians felt assured, their identification was generally correct. Conversely, when they found the identification process challenging, they often misidentified the VCB.
• The authors further noted that, in horses with sinus disease involving the VCB, this structure appears more evident in radiographs compared to horses without sinus disease.

Implications

• Familiarity with the normal radiographic anatomy of the VCB would assist clinicians in identifying horses with sinusitis affecting the ventral conchal sinus (VCS).