Causes of Equine Facial Swelling

Causes of Equine Facial Swelling

1. Atheroma

   • degeneration of the walls of the arteries caused by accumulations of fatty deposits leading to a reduction of circulation and a risk of thrombosis

2. Suture Periostitis

   • new bone thrown up in response to instability of the skull bones. Iatrogenic (from sutures/surgery) or idiopathic

3. Paranasal Sinus Cyst

   • Yearlings or old horses (>12).
   • Congenital abnormality, but may be a relationship with haematoma and epithelial lining damage
   • Epithelial and fibrous capsule containing fluid
     • Causes marked facial swelling and obstruction - turbinate swelling and septal deviation
     • Treatment: removal of cyst and lining (epithelial and fibrous)

4. Paranasal Sinusitis

   • Dx: Rads show fluid-air interface in sinus with dental apical changes
     • Endoscopy confirms origin of discharge
   • PreX: unilateral purulent discharge, ozaenia, pain, +/- haemorrhage
   • Treatment
     • Broad Spec ABs initially then C&S guided
     • Sinus lavage with local anaesthesia
     • Sinus surgery to flush out purulent material and enlarge drianage +/- removal of sinus lining (granuloma risk)

5. Progressive Haematoma

   • Unilateral epistaxis (persistent or intermittent but not profuse), nasal obstruction
   • Dx: Rads, sinoscopy, maybe CT
   • Management
     • inject 10% formalin
     • laser ablation
       • Risk of nerve/brain damage
     • surgical removal via flap
       • Must remove all of ethmoidal lining otherwise return and behave like a tumour

6. Sinunasal Neoplasia

   • older horses >10yo
   • Sarcoma, carcinoma, adenocarcinomas, lymphoma (young). Always highly malignant and locally destructive
     • Radical surgical removal is the only treatment option. Recurrence is common - euthanise
   • Multiple tissue type tumours
     • Cystic, haematomatous, fibrous masses

7. Nutritional Secondary Hyperparathyroidism

   • High phosphorous, low calcium (bran) diet = Ca resorbed excessively from bones which are replaced by fibrous tissue resulting in a large, domed head

8. Facial Trauma

9. Subcutaneous emphysema or haemorrhage

10. Oedema

    • Bilateral jugular obstruction