Endoscopic removal of a molariform supernumerary intranasal tooth (heterotopic polyodontia) in a horse

CASE DESCRIPTION: A 3-year-old Thoroughbred mare was evaluated because of abnormal upper respiratory tract sounds (that had become apparent during race training) of 3 to 4 months' duration. CLINICAL FINDINGS: On initial physical evaluation, there were no abnormal findings. During trotting, an abnormal upper airway expiratory sound was audible. Endoscopic examination revealed a small mass protruding into the right ventral nasal meatus. Radiographic images of the skull revealed no abnormal findings. Computed tomography of the head revealed an abnormal structure in the same location as the mass that was observed during endoscopy. The x-ray attenuation of the mass was identical to that of dental tissue. TREATMENT AND OUTCOME: The mass was surgically removed with endoscopic guidance. On gross examination, the excised mass appeared to be a nearly normal molariform tooth. Histologic examination revealed that it was a well-formed tooth, with no other associated cellular populations. The mass was determined to be a molariform supernumerary intranasal tooth. Six months following discharge from the hospital, the trainer reported that the abnormal respiratory tract sound was no longer audible. During a follow-up endoscopic examination performed at the training facility, no abnormalities were detected. CLINICAL RELEVANCE: In horses, an intranasal tooth should be considered as a differential diagnosis for expiratory stridor. Clear definitions of heterotopic polyodontia, dentigerous cyst, and temporal teratoma can be used to clinically diagnose these separate anomalies. In the horse of this report, computed tomographic findings contributed to determination of a diagnosis and formulation of a treatment plan.