Page 647 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

622 CHAPTER 3

VetBooks.ir 3.51 3.52

Fig. 3.51 Centesis of a sinus cyst, using a 14-gauge Fig. 3.52 Resection of a sinus cyst in a standing
needle driven through the thin overlying maxillary bone, sedated horse.
showing the vivid yellow fluid on the surgeon’s glove.

INTRANASAL FOREIGN BODIES Aetiology/pathophysiology
Epistaxis can result from iatrogenic trauma to any of
Definition/overview the nasal turbinates, with the ethmoturbinates the
This is an uncommon condition in the horse and is most vulnerable and vascular.
usually caused by the aspiration of pieces of wood,
seeds and other vegetative material. Clinical signs Clinical presentation
in acute cases include nasal discomfort with intense The horse presents with epistaxis, which can be very
and persistent sneezing, facial rubbing and epistaxis. mild or can be profuse and is observed almost imme-
More chronic cases will have increasingly puru- diately on passage or withdrawal of a stomach tube
lent and malodourous unilateral nasal discharge. or endoscope.
Diagnosis may be possible in rostral nasal passage
sites by direct visual examination, but more com- Differential diagnosis
monly endoscopic examination of the entire nasal There is a very limited differential diagnosis.
passages will identify the foreign body. Rarely the Probably the most significant is guttural pouch
foreign body is radiopaque and is visible on head mycosis, although this is rare.
radiographs. Treatment by endoscopically-guided
retrieval in the standing sedated horse followed by a Diagnosis
short course of systemic antibiotics and NSAIDs is There is a history of the passage of an endoscope or
usually effective. nasogastric tube. Further investigation is only warranted
if the epistaxis does not stop or recurs without further
IATROGENIC TRAUMA OF nasal intubation. Endoscopy is seldom of any value in
THE NASAL PASSAGES the face of acute haemorrhage, as visibility is limited.

Definition/overview Management
This is a common complication of nasogastric intu- No treatment is necessary as the haemorrhage is
bation or nasal endoscopy. invariably self-limiting. Practically it is useful to