Equis ISSN 2398-2977

Ethmoid: hematoma - chemical ablation

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

Preparation

Procedure

Outcomes

Prognosis

• Guarded: recurrence of lesions is likely.