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  Discussion on Research Summary: CT in Horses with Ethmoid Hematoma
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DrO

Posted on Tuesday, May 29, 2012 - 7:15 am:

It was a surprising finding that almost half of the horses did not have a diagnosis prior to computed tomography. These were horses whos lesions were not viewable by endoscopy. Horses with unexplained nose bleeds that are not visible endoscopically should consider CT where available and affordable.
DrO

J Am Vet Med Assoc. 2012 Jun 1;240(11):1338-44.
Results of computed tomography in horses with ethmoid hematoma: 16 cases (1993-2005).
Textor JA, Puchalski SM, Affolter VK, Macdonald MH, Galuppo LD , Wisner ER.
Source

Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
Abstract

Objective-To determine whether CT provides unique information about the treatment or prognosis for horses with ethmoid hematoma (EH). Design-Retrospective case series. Animals-16 horses with EH. Procedures-Horses with a diagnosis of EH that had undergone a diagnostic CT study were included. Clinical features, treatment, outcome, radiographic and CT images, and histologic specimens were reviewed. Results-CT provided new diagnostic information that affected treatment in 10 of 16 horses. Bilateral disease occurred in 8 of 16 horses and was undetected in 5 horses prior to CT. Paranasal sinus involvement occurred in all horses, but was incompletely defined prior to CT in 7 of 16 horses. The sphenopalatine sinus was affected in 6 of 16 horses as detected on CT; 4 of 6 of these were bilaterally affected. Medical and surgical treatments were performed. Six of 10 horses had a successful outcome, with recurrence in 4 of 10. Five of 6 patients in which treatment addressed all lesion sites identified by CT had a successful outcome. Bilateral disease did not confer a poor prognosis when all affected sites were treated. Sphenopalatine sinus involvement may have been associated with recurrence. Conclusions and Clinical Relevance-CT provided anatomic information that may facilitate effective treatment of horses with EH, particularly in patients with bilateral disease and paranasal sinus involvement. Computed tomography is recommended for patients in which the lesion cannot be viewed endoscopically, when sinus involvement or multifocal disease are suspected, or when the lesion has been unresponsive to treatment.
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