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EQUINE VETERINARY EDUCATION / AE / MAY 2019
TABLE 1: Identification of the dorsal (DCB) and ventral conchal bullae (VCB) on the plain radiographs when compared to radiographs with wire in place
Type
Age (years)
Case 1 Horse <5 Case 2 Horse >5 Case 3 Horse >5 Case 4 Pony >5 Case 5 Pony >5 Case 6 Horse >5 Case 7 Horse >5 Case 8 Horse >5 Case 9 Horse <5 Case 10 Pony >5
RB DCB lateral views
R Correct L Correct R Correct L Correct R Correct L Correct R Correct L Correct R Cd L Cd
R Correct L Correct R Correct L Correct R Correct L Correct R Correct L Correct R Correct L Correct
CB DCB lateral views
Correct Correct Correct Correct Correct Correct Correct Correct Correct
RB VCB lateral views
Correct Correct
CB VCB lateral views
NV NV
Correct Cd Correct Cd Correct Correct
Correct Cd Correct Cd Ro
Correct Cd Correct Correct Correct Correct Correct Correct
Correct Cd Correct Cd Correct Correct
Correct Correct
Correct Correct
Correct Correct Correct Correct
Correct Cd Correct Cd Correct Cd Correct Cd Cd Cd
Correct Correct
Correct Correct
DCB on oblique views
V V
NV NV V V
NV NV NV NV V V V V V V V V
NV NV
VCB on oblique views
NV NV V V V V
NV NV NV NV V V V V
NV NV NV NV NV NV
DCB on DV views
V V
NV V
NV NV NV NV NV V V V V V
NV NV V
NV NV NV
RB, rostral border; CB, caudal border; R, right bulla; L, left bulla; Correct, correct identification of the bulla when compared with radiographs with wire; Cd, the actual position of the bulla limit was found to be more caudal on radiographs with wire when compared to the estimated position on plain radiographs; Ro, the actual position of the bulla limit was found to be more rostral on radiographs with wire when compared to the estimated position on plain radiographs; NV, non visible; V, visible.
TABLE 2: Rostral and caudal limits of the dorsal and ventral conchal bullae in relation to the maxillary cheek teeth
Dorsal conchal bulla % of total
Rostral limits
Caudal Triadan 06
Rostral Triadan 07
Caudal Triadan 07
Rostral Triadan 08
Caudal limits
Rostral Triadan 09
Caudal Triadan 09
Rostral Triadan 10
Caudal Triadan 10
Ventral conchal bulla % of total
Rostral limits
5/20 25% Caudal Triadan 06
10/20 50% Rostral Triadan 07
4/20 20% Caudal Triadan 07
1/20 5% Rostral Triadan 08
Caudal limits
8/20 40% Rostral Triadan 08
2/20 10% Caudal Triadan 08
7/20 35% Rostral Triadan 09
3/20 15% Caudal Triadan 09
Rostral Triadan 10
Discussion
Identification of empyema of the DCB and VCB as a cause of unilateral nasal discharge in horses (Dixon et al. 2015) has recently ignited an interest in the anatomy and clinical imaging of these structures (Froydenlund et al. 2015; Liuti et al. 2015). The radiographic anatomy of the DCB and VCB has been illustrated in a previous textbook (Schebitz and Wilkens
© 2017 EVJ Ltd 3/20 15% 7/20 35% 4/20 20% 4/20 20% 2/20 10% 3/20 15% 10/20 50% 5/20 25% 2/20 10%
1968); however, this is not readily available to most equine practitioners. The recent paper by Liuti et al. (2015) describes the CT appearance of these structures, but a review of their radiographic appearance may facilitate their identification in a general practice setting, where radiography remains the most readily available imaging modality. In Dixon et al.’s paper (2015), 5/10 cases did not have radiography performed, with horses being referred directly for CT examination. Reported radiographic abnormalities specifically relating to the bullae were limited to one case, which had “increased radiopacity of the ventral concha rostral to the sinuses” (Dixon et al. 2015). The current paper is a descriptive study that reports the radiographic appearance, limits, and location of the VCB and the DCB in relation to the maxillary cheek teeth on plain standard radiographic projections. In the horse, the dorsal and ventral nasal conchae are
simple structures, comprising two delicate scrolls of thin, mucosa-covered bone (Dyce et al. 2010). Within each dorsal and ventral nasal concha lies an air-filled bulla. These bullae were initially defined as the bulla situated in the recessus conchae nasalis dorsalis and the bulla situated in the concha nasalis ventralis (Schebitz and Wilkens 1968) and more recently have been described as bulla conchalis ventralis or ‘ventral nasal conchal bulla’ and bulla conchalis dorsalis or ‘dorsal nasal conchal bulla’ (Dyce et al. 2010; International Committee on Veterinary Gross Anatomical Nomenclature 2012). In this study, the DCB was easily identified on straight
lateral views in all the equine heads. The rostral border of the VCB was correctly identified on plain radiographs in all the heads of horses aged >5 years, while the location of the caudal border is more difficult to ascertain on plain
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