Ursachen und chirurgische Therapie von Unterkieferfisteln beim Pferd

Ursachen und chirurgische Therapie von Unterkieferfisteln beim Pferd

Etiology and surgical treatment of mandibular fistula in the horse

Bartmann C P, Bienert-Zeit A

DOI: 10.21836/PEM20100212
Jahr: 2010
Volume: 26
Ausgabe: 2
Seiten: 191-198

During a three year period, 41 horses were referred to the Clinic for Horses with the symptom of a mandibular fistula. Diagnostic procedures included clinical examination with oral examination and insertion of a probe in the sinus tract. Digital radiographic examination including contrast fistulography or with a metal probe within the tract was performed with lateral and oblique projections. Computed tomography of the head was added in 19 of the 41 horses. In 39 of the 41 horses, the origin of the fistula or sinus tract formation could be detected prior to surgery. A sinus tract formation caused by apical cheek teeth infection was present in 31 of the 41 horses with the rostral mandibular cheek teeth P2-P4 (06-09) the most common. In 10 horses the sinus tract formation was a result of traumatic or infectious damage to the mandibular bone or the parotic gland. A bone sequester could be detected in six of those horses. Following diagnostic procedures, surgical treatment was performed in 40 of the horses. One horse did not obtain surgical treatment due to the decision of the owner. In case of dentogenous fistula formation, the treatment of the affected cheek teeth included tooth repulsion, oral extraction or endodontic therapy. The sinus tract and infected and necrotic tooth and bone tissue were resected completely or bone curettage was performed. In two horses, a second surgical intervention was undertaken due to sequester formation or continuing osteomyelitis and purulent exudation. One horse had to be euthanatized because of a limb fracture. Following surgery, all horses could be discharged with complete or uncomplicated wound healing. Complete primary or secondary wound healing could be confirmed in all the horses during the hospitalization or as a result of a follow-up control.