Ethmoid hematoma
Encyclopedia
Ethmoid hematoma is a progressive and locally destructive disease of horse
s. It is indicated by a mass in the paranasal sinus
es, that resembles a tumor
but is not neoplastic by any means. The origins and causes of the ethmoid hematoma are generally unknown. Large hematomas usually start within the ethmoid labyrinth, and smaller ones tend to begin on the sinus floor.
The hematoma usually extends into the nasal passage. A growing hematoma causes pressure necrosis
of the bone surrounding the hematoma, but only on rare occasions does it cause facial distortion. It is most commonly seen in horses older than 6 years. Mild, persistent, spontaneous, intermittent, and unilateral epistaxis is the most common sign clinically.
; the lesion can be seen extending into the nasal passages on endoscopic examination and can be demonstrated on radiographs
. Further elucidation can be obtained with MRI or CT
in cases which are more widespread or invasive.
treatment with an Nd:YAG laser
looks to be a possibility for permanent removal.
There has been some success using intra-lesional injections of formalin, performed via endoscopy.
Horse
The horse is one of two extant subspecies of Equus ferus, or the wild horse. It is a single-hooved mammal belonging to the taxonomic family Equidae. The horse has evolved over the past 45 to 55 million years from a small multi-toed creature into the large, single-toed animal of today...
s. It is indicated by a mass in the paranasal sinus
Paranasal sinus
Paranasal sinuses are a group of four paired air-filled spaces that surround the nasal cavity , above and between the eyes , and behind the ethmoids...
es, that resembles a tumor
Tumor
A tumor or tumour is commonly used as a synonym for a neoplasm that appears enlarged in size. Tumor is not synonymous with cancer...
but is not neoplastic by any means. The origins and causes of the ethmoid hematoma are generally unknown. Large hematomas usually start within the ethmoid labyrinth, and smaller ones tend to begin on the sinus floor.
The hematoma usually extends into the nasal passage. A growing hematoma causes pressure necrosis
Necrosis
Necrosis is the premature death of cells in living tissue. Necrosis is caused by factors external to the cell or tissue, such as infection, toxins, or trauma. This is in contrast to apoptosis, which is a naturally occurring cause of cellular death...
of the bone surrounding the hematoma, but only on rare occasions does it cause facial distortion. It is most commonly seen in horses older than 6 years. Mild, persistent, spontaneous, intermittent, and unilateral epistaxis is the most common sign clinically.
Diagnosis
Diagnosis of the condition is best suited to endoscopyEndoscopy
Endoscopy means looking inside and typically refers to looking inside the body for medical reasons using an endoscope , an instrument used to examine the interior of a hollow organ or cavity of the body. Unlike most other medical imaging devices, endoscopes are inserted directly into the organ...
; the lesion can be seen extending into the nasal passages on endoscopic examination and can be demonstrated on radiographs
X-ray
X-radiation is a form of electromagnetic radiation. X-rays have a wavelength in the range of 0.01 to 10 nanometers, corresponding to frequencies in the range 30 petahertz to 30 exahertz and energies in the range 120 eV to 120 keV. They are shorter in wavelength than UV rays and longer than gamma...
. Further elucidation can be obtained with MRI or CT
Computed tomography
X-ray computed tomography or Computer tomography , is a medical imaging method employing tomography created by computer processing...
in cases which are more widespread or invasive.
Treatment
Treatment most commonly involves the removal of the complete lesion during a single procedure, via the frontonasal bone flaps; recurrence is likely. AblationAblation
Ablation is removal of material from the surface of an object by vaporization, chipping, or other erosive processes. This occurs in spaceflight during ascent and atmospheric reentry, glaciology, medicine, and passive fire protection.-Spaceflight:...
treatment with an Nd:YAG laser
Nd:YAG laser
Nd:YAG is a crystal that is used as a lasing medium for solid-state lasers. The dopant, triply ionized neodymium, typically replaces yttrium in the crystal structure of the yttrium aluminium garnet , since they are of similar size...
looks to be a possibility for permanent removal.
There has been some success using intra-lesional injections of formalin, performed via endoscopy.