Interactive Case Tutorial Case 02 Skull Instructions Review

Interactive Case Tutorial Case 02 Skull

Instructions � Review the history and signalment for the client � Evaluate the radiographs provided � Explore the interactive images and compare the answers given with your own interpretations. When you’ve clicked on the image, click the same spot again to make the label disappear. � Answer the questions regarding a diagnosis and recommendations � Review the radiologist’s findings

Case Presentation � Signalment: 20 year old Appaloosa gelding � History: presents for evaluation of dental and sinus disease due to several months of nasal discharge � Study: lateral, DV, right over left oblique, left over right oblique of nasal passages

Lateral Granular soft tissue and mineral material in maxillary and frontal sinuses Diastema Short tooth roots due to age

DV Granular soft tissue and mineral material in maxillary and frontal sinuses Granular soft tissue and mineral material in nasal cavity

Right over left oblique Sclerosis Granular soft tissue and mineral material in maxillary and frontal sinuses Diastema

Left over right oblique Sclerosis Granular soft tissue and mineral material in maxillary and frontal sinuses Diastema

Conclusions � Provide a diagnosis based on your findings. Submit Feedback The findings are suggestive of impacted feed material in the sinuses and nasal cavity secondary to oro-nasal fistula Continue

Recommendations � Provide your recommendation for this client. Submit Feedback Frontonasal sinusotomy. Sinuses were completely packed with fetid feed material and pus. Diastema between teeth 110/111 and 210/211 communicate with the maxillary sinuses and are the likely source of the problem. Polymethylmethacrylate was used to fill the diastema from the sinus side. Sinuses were thoroughly lavaged and flushed daily through catheters Continue

Findings � Within the maxillary and frontal sinuses bilaterally is a large quantity of granular soft tissue to mineral opacity material which also extends into the nasal cavity bilaterally � Sclerosis is present surrounding the roots of the fourth premolar and all three molars in both maxillary arcades � Diastema present between second and third maxillary molars bilaterally

Follow-up � The procedure was repeated several times over the next two years � Three years later the patient died

The End