An ear fistula, also known as an ear cyst or ear base fistula in horses, describes a malformation occurring on one or both sides consisting of scattered tooth buds located as a cyst at the base of the horse's ear. Animals between three and twelve months old are most commonly affected.
The disease is triggered by a congenital malformation of the horse's tooth buds. The exact causes of this malformation are unknown. A hereditary predisposition has not yet been proven.
During the foal's embryonic development, cells responsible for tooth development may end up in other places, such as the base of the ear. This results in bony tooth formations that become inflamed in the wrong place, leading to the formation of a fistula in the horse's ear. Through the so-called fistula tract (a tube-like connection), a purulent, milky discharge reaches the skin surface and empties from a small fistula opening at the lower edge of the ear.
The scattered tooth buds are always supernumerary teeth; the horse's dentition is otherwise normally developed.
The affected horses are usually presented to the veterinarian because of this purulent discharge from the ear. Often, the owner only notices the dried secretion running down the side of the head. Occasionally, painless swelling in the ear area can also be seen. The skin around the fistula opening may be inflamed.
In the majority of cases, the affected horses show no signs of pain or general discomfort. However, if large enough, the tooth formations can lead to riding problems and, in the worst case, neurological symptoms due to displacement of cerebral substance.
The general and specific examination, along with your detailed preliminary report on the onset and extent of the symptoms, will provide your veterinarian with valuable information about the disease. During the special examination, they can sometimes detect enlargements or hardening at the base of the fistula by palpation, but more often by probing the fistula with a flexible probe. If manual pressure is applied to this structure from the outside, a large amount of secretion is usually discharged.
To confirm the diagnosis and determine the location and extent of the tooth formation, an X-ray examination should always be performed. Ultrasound examinations and biopsies (tissue sampling) of the cyst can also help to confirm the diagnosis.
In cases of unclear X-ray images or difficult location of the cyst (e.g., very close to the skull bone), an additional CT or MRI examination is recommended, as these cross-sectional imaging techniques allow for a superimposition-free representation and thus provide accurate information about the number and location of the supernumerary tooth formations.
The only promising treatment is surgical removal of the entire cyst. The horse is placed under general anesthesia so that the entire fistula, including the tooth, can be removed.
After successful surgical removal of the tooth buds, the chances of a complete cure are very good.
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