Ragle Claude A, de Mira Monica C, Pearson Lisa K, Coelho Joana C
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA.
J Am Vet Med Assoc. 2009 Jul 15;235(2):184-8. doi: 10.2460/javma.235.2.184.
A 2-year-old Quarter Horse was evaluated because of a progressive left-sided facial deformity and unilateral nasal and ocular discharge.
Physical examination revealed convexity of the left frontonasal region, left-sided nasal and ocular discharge, and decreased air flow through the left nares. Radiography and computed tomography revealed an extensively mineralized mass occupying most of the left paranasal sinuses.
The mass was surgically debulked, but complete removal was precluded because the mass was tightly adhered to the frontal and maxillary bones. Results of histologic examination of the mass were consistent with a diagnosis of osteoma. The horse developed transient pyrexia and colic following surgery, and postoperative radiography revealed gas opacities in the lateral ventricles of the brain, consistent with iatrogenic pneumocephalus. However, the horse did not develop any neurologic signs and was performing normally 2 years after surgery.
Findings reinforce concerns that paranasal sinus surgery in horses can be associated with intracranial complications such as pneumocephalus. In horses with a mass involving the paranasal sinuses, computed tomography may be helpful in determining the boundaries of the mass and formulating a surgical treatment plan.
一匹2岁的夸特马因左侧面部进行性畸形以及单侧鼻腔和眼部流出物而接受评估。
体格检查发现左侧额鼻区域凸出、左侧鼻腔和眼部有分泌物，且左侧鼻孔气流减少。放射学检查和计算机断层扫描显示一个广泛矿化的肿块占据了大部分左侧鼻窦。
该肿块通过手术进行了减容，但由于肿块与额骨和上颌骨紧密粘连，无法完全切除。肿块的组织学检查结果与骨瘤诊断一致。这匹马在手术后出现了短暂发热和腹痛，术后放射学检查显示脑侧脑室有气体混浊，符合医源性气颅。然而，这匹马没有出现任何神经症状，术后2年表现正常。
这些发现强化了人们对马鼻窦手术可能与气颅等颅内并发症相关的担忧。对于患有涉及鼻窦肿块的马匹，计算机断层扫描可能有助于确定肿块边界并制定手术治疗方案。
