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Definition

Sinusitis is the accumulation of suppurative exudate within the paranasal sinuses of the horse and typically results in malodorous nasal discharge with or without pyrexia.

Risk factors

 Prolonged or repeated nasogastric intubation

 Contamination of the nasal cavity with blood or gastrointestinal reflux, especially during general anesthesia [18, 19].

 Prolonged intubation is a significant risk factor in people [20]

Pathogenesis

Unilateral or bilateral sinusitis has been described as a rare complication of nasogastric intubation [18, 19]. Pathogenesis is assumed to be related to overwhelming of normal sinus defense mechanisms by impediment of normal sinus drainage (inflammation and swelling of mucosa secondary to indwelling tubes), increased bacterial load (prolonged intubation, use of a contaminated tube, or feed contamination of sinuses), or propagation of bacterial growth (blood contamination).

Prevention

Nasogastric tube‐associated sinusitis may be minimized by prophylactically lavaging the nasal passages if they are contaminated with gastrointestinal reflux during colic surgery and by using clean, disinfected nasogastric tubes for as short a time as possible [18].

Diagnosis

Clinical signs are the development of suppurative nasal discharge and fever [18]. Radiographs of the paranasal sinuses and endoscopy of the upper respiratory tract can localize the disease to the paranasal sinuses.

Treatment

Treat with systemic antimicrobial therapy and lavage of the affected sinuses via trephination. Sinusotomy via sinonasal flap may be necessary in selected cases.

Expected outcome

Prognosis with appropriate treatment should be good.