Surgical affections of sinuses
Surgical affections of sinuses in animals are pus in the sinuses, Inflammation of sinus (Sinusitis), foreign bodies, Parasites etc.
The sinuses of the skull are air cavities in bones, which are lined by mucous membrane in the fresh state.
Surgical affections of sinuses are-
Pus in sinuses
Etiology of pus
Etiology of pus or empyema in sinuses may be primary or secondary.
Primary causes are Injuries of the wall like contusion, open wound- causing bleeding into the cavity or Pyogenic organisms may multiply and cause suppuration.
Primary causes are dental affections with suppuration of the alveoli and root of teeth and perforation of their walls into the sinus.
Clinical signs of pus
- Nasal discharge- mucopurulent, non-offensive
- Pus- grayish, yellowish-white and with streaks of blood occassionally
- Sinus- swelling, dullness on percussion
- Lacrimation , mucus plugs
Diagnosis of pus
Diagnosis of pus can be done by respiratory noise (Rule out glanders by Mallein test) and by exploration of the sinus through an opening made by a trephine.
Treatment of pus
Drainage can be facilitated by extraction of the affected tooth. Flush the cavity with diluted povidone Iodine
Administration of antibiotics following an antibiogram test.
Dental fistula
Dental fistula or pus in antrum is the empyema of maxillary sinus due to an ascending infection from the roots of the 4th upper cheek tooth (Alveolar periostitis). Excoriation and liquefaction of the bone leading to a fistulous tract communicating the external skin surface.
Symptoms of dental fistula
Small sinus wound 1-2 cm below the inner canthus of the eye of the affected side with oozing of pus. Scratching at the site – ulceration of skin – not responding to conventional line of treatment.
In dog, the pus is seen to escape through a small opening on the skin below the lower eye lid. There may be pain and difficulty in mastication. But in many cases, there is no noticeable involvement of the tooth.
In horses, dental fistula affecting the upper molars may either open into the nasal chambers or into the maxillary sinus or on the outside skin and discharge may be seen through the nostrils.
Diagnosis of dental fistula
Diagnosis of dental fistula is done by use of x-rays (Alveolar abscess can be demonstrated radiographically in a medial oblique projection with the affected maxilla in contact with the film).
Treatment of dental fistula
Removal of the affected tooth (Exodontia) and the necrosed pieces of bone are the treatment.
In the case of carnassial tooth, in most cases, the single posterior root will be involved.
Local and systemic antibiotics are given.
Sinusitis
Sinusitis is the inflammation of the sinuses.
Etiology of sinusitis
- Frontal sinusitis in cattle associated with dehorning
- Maxillary sinusitis associated with infected teeth
- Infection
Clinical signs of sinusitis
- Frontal sinusitis occurs immediately after dehorning because the wound is still open
- Sinusitis may be unilateral
- Anorexia
- Pyrexia
- Nasal discharge
- Dysponea
- Foul smelling breath
Diagnosis of sinusitis
- Percussion: may reveal a dull sound over the affected sinus
- Radiographs: fluid in the sinus, dental disease, bone lysis
- Cytology of the discharge
Treatment of sinusitis
- By draining the affected sinus
- Maxillary sinusitis-infected tooth can be repelled
- Once drainage has been established, the sinus can be lavaged daily with antiseptic solution, preferably with potassium per magnate.
- Parenteral antibiotic
- NSAIDs
Sinus flushing is performed through a trephine hole made just lateral to the midline on a line joining the rostral margins of the supra orbital process. An intravenous tubing is usually preferred to flush with trypsin solution.
Sinus drainage is more radical approach. Periosteum is elevated to remove the bony layer over the sinus with rongeurs to effect drainage.
Sinusitis in animals can be controlled by dehorning calves at young age by closed dehorning technique, dust and fly control.
Foreign bodies in sinus
Foreign bodies in the sinuses are not commonly seen.
Smooth, clean foreign bodies without causing much damage to the tissues may remain ‘in situ’. Some foreign bodies set up the condition of “pus in the sinus“.
Parasites in sinus
Parasites in sinus are linguatula (in frontal sinuses of dogs) and Oestrus ovis (in frontal and maxillary sinuses of sheeps).
Clinical signs of parasites in sinus
Mucoid discharge, sneezing and snoring and animal rubs the nose with the claws could be seen.
Treatment of parasites in sinus
After trephining, antiseptics can be injected into the sinus to control infection. Parasites may be removed mechanically with forceps.