Equis ISSN 2398-2977

Ethmoid: hematoma - chemical ablation

Synonym(s): Transendoscopic chemical ablation

Contributor(s): Tim Brazil, David Moll, Dwayne Rodgerson

Introduction

  • Formaldehyde coagulates proteins by hydrolysis   →   reduction in tissue volume and reduced hemorrhage.
  • Ethmoid hematomas   Ethmoid: hematoma  cause clinical signs relating to impingement in the paranasal sinuses and nasal passages, secondary infection and spontaneous bleeds.

Uses

  • Reduction in mass of ethmoid hematoma   Ethmoid: hematoma  :
    • Small lesions ideal.
    • Location in the nasal passage ideal.
  • Follow up treatment of recurring lesions that have been surgically ablated.

Advantages

  • Done in standing sedated horse   Anesthesia: standing chemical restraint  .
  • Minimum specialized equipment required.
  • Can be repeated.
  • Easy to evaluate.
  • High percentage of cases result in remission of clinical signs.

Disadvantages

  • Formaldehyde (formalin) is toxic and irritant.
  • 60% complete resolution of lesion by endoscopic evaluation.
  • Access by endoscopy may be inadequate   →   need to use trephine   Head: trephination  and/or bone flap   Paranasal sinus: bone flap technique  to access lesions projecting into paranasal sinus.
  • Not suitable for large lesions that are causing acute clinical signs.

Requirements

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Preparation

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Procedure

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Outcomes

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Prognosis

  • Guarded: recurrence of lesions is likely.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Schumacher J et al (1998) Transendoscopic chemical ablation of progressive ethmoidal hematomas in standing horses. Vet Surg 27, 175-181 (Detailed description of the technique and case results) PubMed.
  • Bell B T, Baker G J, Abbott L C, Foreman J H & Kneller S K (1995) The macroscopic vascular anatomy of the equine ethmoidal area. Anat Histol Embryol 24 (1), 39-45 PubMed.


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