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The prevalence of temporal bone fractures is high in horses with severe temporohyoid osteoarthropathy
Authors:Jacqui Tanner  Mathieu Spriet  Pablo Espinosa‐Mur  Krista E Estell  Monica Aleman
Abstract:Temporohyoid osteoarthropathy is a well‐recognized cause of equine neurologic disease. Temporal bone fractures associated with temporohyoid osteoarthropathy have been recognized with CT, however, little information is available regarding these fractures. The aims of this retrospective analytical study were to assess the prevalence of these fractures and to describe the specific configurations and associated imaging and clinical features. Fracture of the temporal bone was identified with CT in 16 of 39 included horses. All fractures were unilateral, minimally displaced and extended through the temporal bone in a rostrodorsal to caudoventral orientation. Two fracture configurations were identified: in nine cases, the fracture extended the full width of the petrous pyramid into the cranial vault and in seven cases, the fracture only extended through the lateral part of the petrous temporal bone, not involving the cranial vault. Fusion of the temporohyoid joint was present in 13 of the 16 fracture cases. Quarter Horses were over‐represented in the fractured population (14/16). All horses with fractures had ipsilateral neurologic deficits. Patient outcomes were not significantly different between temporohyoid osteoarthropathy horses with and without temporal bone fractures (P = 0.68). However, six of the nine patients with cranial vault involvement did not return to their previous use. Findings support previous studies indicating that temporal bones should be carefully assessed for concurrent fractures when temporohyoid osteoarthropathy is identified in CT images, especially when there is fusion of the temporohyoid joint. An improved awareness of specific fracture configurations will help with detection of these fractures.
Keywords:computed tomography  cranial nerves  facial paralysis  neurology  vestibular syndrome
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