An 11-year-old American Quarter Horse gelding was referred to the JT Vaughan Large Animal Teaching Hospital at Auburn University, College of Veterinary Medicine, for investigation of acute and severe right-sided facial swelling and nasal discharge. Standing computed tomographic (CT) examination of the head identified severe soft tissue swelling surrounding the right mandible, emphysema within the soft tissues tracking along fascial planes and right-sided caudal and rostral maxillary sinusitis. Using CT identification and ultrasound guidance, several targeted fasciotomies were created into the right masseter, cranial cervical musculature, supraorbital space and caudo-medial aspect of the mandible. The right-sided sinusitis was treated by right conchofrontal sinus trephination and lavage. Aerobic and anaerobic cultures obtained from the fasciotomy sites and conchofrontal sinus both yielded Prevotella intermedia and Peptostreptococcus asaccharolyticus. During hospitalisation, serial, standing CT examinations were performed for monitoring case progression and guiding further fasciotomies in the face of continued myonecrosis. Follow-up CT performed at 1 month showed resolution of the emphysema and presence of chronic right ventral conchal sinusitis. The sinusitis was treated by fenestration of the right ventral concha with a diode laser via the nasal passage.

中文翻译：

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连续站立计算机断层扫描在诊断、治疗和监测患有急性头部肌坏死的马中的应用

一头 11 岁的美国夸特马阉马被转诊到奥本大学兽医学院的 JT Vaughan 大型动物教学医院，以调查急性和严重的右侧面部肿胀和流鼻涕。头部的站立计算机断层扫描 (CT) 检查发现右下颌骨周围有严重的软组织肿胀，软组织内的肺气肿沿着筋膜平面追踪，以及右侧尾侧和头侧上颌窦炎。使用 CT 识别和超声引导，在右侧咬肌、颅颈肌组织、眶上间隙和下颌骨的尾内侧方面进行了几个靶向筋膜切开术。右侧鼻窦炎采用右侧甲状窦环钻和灌洗治疗。Prevotella intermedia和Peptostreptococcus asaccharolyticus。在住院期间，进行了连续的站立 CT 检查以监测病例进展并在面对持续的肌坏死时指导进一步的筋膜切开术。在 1 个月时进行的 CT 随访显示肺气肿消退并存在慢性右腹侧甲状窦炎。鼻窦炎通过用二极管激光经鼻道开窗治疗右腹外甲。