Page 256 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Musculoskeletal system: 1.6 The hea d 231

VetBooks.ir 1.435 1.436

Fig. 1.436 An indwelling catheter placed through a
trephine hole in the facial bone of the head, allowing
intermittent flushing of the sinus compartments.
Fig. 1.435 Endoscopic photograph of the sinus
drainage angle showing haemorrhage emanating from
the sinuses.

NASOFRONTAL SUTURE PERIOSTEITIS 1.437

Definition/overview
Nasofrontal suture periosteitis is a bony swell-
ing, usually idiopathic but commonly thought to
be trauma related, which most commonly appears
at the joint between the frontal and nasal bones
(Fig. 1.437). It is normally non-painful and its only
significance is as a cosmetic blemish; however, it may
have the radiographic and ultrasonographic appear-
ance of a healing fracture.

Diagnosis
The clinical appearance is synonymous, but radio-
graphic (Fig. 1.438) and ultrasonographic examina-
tion can be useful (Fig. 1.439).

Management
Conservative management with anti-inflammatories
and monitoring is normally curative, but complete
resolution of the swelling is rare.
Fig. 1.437 Extensive new reaction along the suture
lines of adjacent bones of the head, both in the
midline and underneath the left eye. (Photo courtesy
Graham Munroe)