Rubens Peres Mendes 1,2,✉, Aymara Eduarda de Lima 3, Reginaldo da Cunha 1,2, Mauricio Jose Bittar 4, Christian Carlstron Vasconcelos 2, Diego Darley Velasquez Piñeros 5, Rodrigo Romero Corrêa 1
Background
Radiographic evaluation remains essential for diagnosing equine sinonasal disorders, despite the superior diagnostic accuracy of computed tomography (CT). Conventional projections often obscure key structures like the conchal sinuses and bullae due to anatomical superimpositions. This study aimed to develop and assess a novel radiographic projection—lateral 75° dorsal–lateral ventral oblique view—for improved visualization of these regions.
Methods
Six cadaveric equine heads, free from sinonasal or dental pathology, were used. The heads were prepared via conchotomy and filled with radiopaque or silicone materials to delineate anatomical structures. The new projection was executed with the mandible displaced laterally toward the side of interest and the X-ray beam directed dorsoventrally at a 75° angle. Radiographic clarity, reduction in overlap, and reproducibility were evaluated by blinded reviewers.
Results
The novel projection allowed accurate identification of the dorsal and ventral conchal sinuses and bullae. The partial lateral mandible displacement and angled X-ray beam minimized overlap of cheek teeth and conchal structures. The projection clarified boundaries of the sinuses and bullae and visualized septations within the dorsal conchal bulla. Anatomical landmarks for these structures were clearly depicted, enhancing interpretive accuracy.
Limitations
This study used cadaver heads with an average age of 14.5 years, which may not fully represent radiographic appearances in younger horses with less dental eruption. The results are specific to the preserved specimens and experimental setup, and clinical applicability requires further validation in live horses with pathology.
Conclusions
The lateral 75° dorsal–lateral ventral oblique projection enhances radiographic visualization of equine conchal structures, offering improved diagnostic capabilities in sinonasal disease. It is recommended as a complementary projection in radiographic examinations of horses with suspected sinonasal disorders.
Complementary lateral 75° dorsal–lateral ventral oblique. Caudal view (A). X-ray beam at a 75° angle to the left, combined with dislocation of the mandible to the same side. Dorsal view (B). X-ray beam at a 75° angle to the right, combined with dislocation of the mandible to the same side. Lateral view (C). Position of the X-ray beam relative to the imaging plate. Frontal view (D). A radiographic mouth speculum (Pro Horse Dental) for displacement toward the side of interest (partial lateral excursion). Image for illustrative purposes only.
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