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| + | *Slowly expanding non-neoplastic mass of horses |
| − | Also know as: '''''PEH — Ethmoid Haematoma'''''
| + | *Originates from submucosa of ethmoidal labyrinth |
| − | | + | *Either from nasal or sinusal portion of ethmoid labyrinth |
| − | == Introduction ==
| + | *Unilateral, can extend to nostrils or choanae |
| − | This condition is a slowly expanding non-neoplastic mass of horses, that occurs in the submucosa of the ethmoid labyrinth. The cause of the condition is unknown and there are no known risk factors. The mass may sometimes arise subsequently to [[Rhinitis#Chronic rhinitis|chronic inflammation]].
| + | *Rarely elsewhere in sinuses |
| − | It can occur in either the nasal or sinus portion of ethmoid labyrinth and may rarely occur elsewhere in the sinuses. The mass is usually unilateral and can extend to the nasal cavity, paranasal sinuses and nasopharynx causing destruction of tissue.
| + | *Expands to nasal cavity, [[Paranasal Sinuses Hyperplastic and Neoplastic - Pathology|paranasal sinuses]], [[Nasopharynx Hyperplastic and Neoplastic - Pathology|nasopharynx]] causing destruction of tissue |
| − | | + | *Micro - haemorrhage, calcification of connective tissue fibres |
| − | == Signalment ==
| + | *[[Aspergillus spp.|''Aspergillus'' spp.]] may be present on the lesion |
| − | It can occur in horses of any age, but any horse younger than three years old rarely contracts the disease. There is a breed predilection for Arabian and Thoroughbred horses. There is no sex predilection.
| + | *May cause [[Respiratory System Clinical Signs - Pathology#Epistaxis|epistaxis]] |
| − | | + | *Can recur after surgical excision |
| − | == Clinical Signs ==
| + | *May arise subsequently to [[Rhinitis#Chronic rhinitis|chronic inflammation]] |
| − | Signs include [[Epistaxis - Horse|epistaxis]] or a serosanguinous nasal discharge, abnormal respiratory noise, halitosis, dyspnoea and coughing. The animal may also shake its head frequently. Some cases will have a facial deformity and there may be a mass at the nares. Other horses may exhibit no clinical signs.
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| − | == Diagnosis ==
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| − | History, signalment and clinical signs can be characteristic of the disease, but differentials such as [[Guttural Pouch Mycosis|guttural pouch mycosis]], neoplasia, nasal trauma and [[Exercise Induced Pulmonary Haemorrhage|exercise induced pulmonary haemorrhage]] need to be excluded by endoscopic evaluation.
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| − | Upon '''endoscopy''', a yellow-green mass is present and may be covered in [[Aspergillus spp.|''Aspergillus'' spp.]]. The location of the mass is usually diagnostic but a grab biopsy by endoscopy will provide a definitive diagnosis.
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| − | Other imaging such as '''radiographs''' can be undertaken and will show an abnormal opacity with smooth margins. There may also be the presence of fluid lines on radiographs. CT scan will reveal more detail of the lesion.
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| − | == Treatment and Control ==
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| − | Treatment options include '''surgical removal''' via a frontal sinus flap with the horse standing. '''Cryotherapy''' can also be performed in the standing horse and causes minimal haemorrhage, however it can only be used on smaller lesions. '''Laser removal''' is less effective as it requires multiple treatments, it can however be performed in the standing horse. '''Chemical ablation''' is the final treatment option and involves the use of 4% formaldehyde solution. This can also be performed with the horse standing, but requires multiple treatments. The lesion is injected with the solution endoscopically or through a hole in the sinus. This treatment is relatively cheap but complications can include blindness and death if it penetrates the brain.
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| − | == Prognosis ==
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| − | Prognosis is guarded to poor regardless of treatment and recurrence is common (15 - 45%) regardless of which treatment is undertaken.
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| − | {{review}}
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| − | {{OpenPages}}
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| | [[Category:Nasal Cavity - Hyperplastic/Neoplastic Pathology]] | | [[Category:Nasal Cavity - Hyperplastic/Neoplastic Pathology]] |
| | [[Category:Respiratory Diseases - Horse]] | | [[Category:Respiratory Diseases - Horse]] |
| − | [[Category:Paranasal Sinuses - Pathology]]
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| − | [[Category:Nasopharynx - Pathology]]
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| − | [[Category:Respiratory System - Hyperplastic/Neoplastic Pathology]]
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| − | [[Category:Expert Review - Horse]]
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