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Respiratory: radiography – upper respiratory tract

ISSN 2398-2977

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Introduction

  • The extrathoracic part of the respiratory tract is well suited to radiographic examination.
  • Suitable film quality can be obtained using portable equipment.
  • Radiographic examination is helpful in evaluating the nasal passages, paranasal sinuses, guttural pouches, pharynx, larynx and trachea.
  • It is a valuable adjunct to endoscopy   Respiratory: endoscopy  .

Uses

  • Evaluation of the nasal passages, paranasal sinuses, guttural pouches, pharynx, larynx and trachea.
  • Size and location of space-occupying intraluminal lesions especially in paranasal sinuses with cysts or neoplasia   Respiratory: neoplasia    Paranasal sinus: cyst - radiograph  .
  • Axial measurement of airway diameter and length of structures, eg epiglottic length in dorsal displacement of the soft palate   Soft palate: dorsal displacement  .
  • Evaluation of extraluminal lesions, eg retropharyngeal abscessation   Pharynx: retropharyngeal abscess 02 - LM radiograph  , laryngeal mineralization in arytenoid chondritis   Larynx: arytenoid chondritis    Larynx: calcification - radiograph  .
  • Assessment of swallowing reflex using barium sulfate contrast media, eg post-laryngoplasty   Larynx: laryngoplasty  .
  • Detection of fluid lines in air filled cavities, eg paranasal sinuses and guttural pouches   Paranasal sinus: sinusitis 04 - LM radiograph  .
  • Contrast arteriography in guttural pouch mycosis   Guttural pouch: mycosis    Guttural pouch: mycosis 05 - angiography  .
  • Assessment of tooth roots in cases with sinusitis.

Advantages

  • Non-invasive diagnostic technique.

Disadvantages

  • Poor visualization of the soft tissues structures.

Alternative techniques

Time required

Preparation

  • 5 min.

Procedure

  • 10 min.

Requirements

Materials required

Minimum equipment

Preparation

Restraint

Technique

Approach

Step 1 - Views

  • Head and neck: standing erect and recumbent lateral views centerd over the area of interest.
  • Ventro-dorsal and oblique head views (latter especially relevant in investigating dental disease   Teeth: periodontal disease  ).

Step 2 - Exposure

  • Increase kV and reduce MA to improve soft tissue contrast.

Aftercare

Outcomes

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Garrett  K S (2012) Advances in diagnostic imaging of the larynx and pharynx. Equine Vet Educ 24 (1), 17-18 VetMedResource.