Surgical treatment of progressive ethmoidal hematoma aided by computed tomography in a foal.

This study describes a case of progressive ethmoidal hematoma (PEH) in a 4-week-old Belgian filly (young horse) which was successfully treated through surgical removal. The procedure was planned and the extent of the mass determined using computed tomographic images. One year after the surgery, the horse showed significant improvement, with its facial appearance returning to normal.

Background

• The subject of this study was a 4-week-old Belgian filly demonstrating symptoms such as a respiratory stridor, epistaxis, and facial enlargement over its left paranasal sinuses. These symptoms had been progressively worsening since its birth.
• Progressive ethmoidal hematoma (PEH) is a rare condition, especially in neonate equines, making this case unusual. This condition was diagnosed on the basis of the histologic appearance of the mass.

Method

• Computed tomographic images of the horse’s head were obtained while it was under general anesthesia. These images were crucial for determining the nature and extent of the soft-tissue mass, and thereby useful in planning the surgical intervention.

Results

• The surgical removal of the PEH was successful. Using a frontonasal bone flap, the mass was excised.
• The rapid enlargement of the mass, facial deformity, and the minimal amounts of nosebleeds and interoperative bleeding were atypical signs of PEH in this foal.
• Post-surgery, the foal experienced a return to normalcy in facial appearance and nasal septum position. The abnormal appearance of the ethmoid region, as seen on endoscopic evaluation, was notably reduced.

Conclusion

• 12 months after the operation, the foal’s condition demonstrated significant improvement and its facial appearance was back to normal.
• This study reinforces the efficacy of surgical intervention in treating PEH, particularly when aided by computed tomography for planning and determining the extent of the mass. It also highlights the variability of symptom presentation in PEH cases.