Abstract title:
Computed tomography of the horse’s head with a special focus on dental structures – significance in the multimodal diagnostic concept
High-resolution computed tomography (CT) is currently considered the most sensitive imaging technique for three-dimensional representation of complex pathologies of the equine head. In particular, the anatomical features of hypsodont teeth with pronounced reserve crowns, multiple pulp horns and the close topographical relationship to the paranasal sinuses often lead to diagnostic limitations due to superimposition in conventional X-rays. CT enables a superimposition- free, high-resolution assessment of dentoalveolar and sinonasal structures.
At the same time, it is important to emphasise that CT alone does not usually allow a definitive diagnosis to be made. Rather, it only reveals its maximum diagnostic value in the context of a structured, multimodal examination process. A careful medical history, including documentation of the course of the disease, previous treatments and clinical symptoms (e.g. unilateral nasal discharge, feeding problems, pain response), forms the basis for a targeted interpretation of the images.
Clinical general and specific examinations – including inspection, palpation, intraoral examination, probing and percussion – provide essential information on the location and relevance of possible lesions. Endoscopic procedures also allow direct assessment of the nasal passages, the ethmoid region and the sinus drainage pathways, and provide functional information that often cannot be obtained, or at least not as well, with static computed tomographic imaging. Ultrasound can also be used to assess superficial bone changes and soft tissue reactions, or to assist with puncture-based diagnostics.In the case-based context presented, CT was shown to have high sensitivity, particularly in the detection of subtle periapical osteolysis, neoplastic processes or alveolar destruction. It allows for the precise identification of pathological processes and a differentiated analysis of the paranasal sinuses. Nevertheless, the interpretation of the findings requires critical correlation with clinical and endoscopic results in order to distinguish incidental findings from clinically relevant lesions.
The CT data sets are therefore not an isolated endpoint, but an integral part of an overall diagnostic concept, allowing precise therapy planning and realistic prognosis assessment. In summary, the case studies underscore the importance of CT in the modern management of complex equine head disorders, but equally emphasise the need for a structured, multimodal diagnostic approach to avoid overinterpretation and unnecessary interventions.
