Primary paranasal maxillary hematoma: clinical characteristics, diagnosis and surgical treatment

Background: The equine paranasal sinus have a complex anatomy and large compartiments. For this reason, deseasesthat affect these structures may develop for long periods before the animal show any clinical signs, making it difficult tostablish a definitive diagnosis and institute an adequate treatment. Usually, maxillary hematomas reports come from progression of ethmoidal hematomas, and the descriptions of primary maxillary hematomas are rare. This study aims to reportthe clinical features, diagnosis and treatment of a case of a maxillary hematoma not associated with ethmoidal turbinates.Case: An 8-year-old male horse, Mangalarga Paulista, was referred to the Centro de Apoio ao Ensino e Pesquisa FMVZUSP with history of nasal bleeding for over a year. The animal presented deformity on the right side of the face, with significant volume increase on the maxillary bone region and dull sound at percussion, in addition to great painfull sensibilitywhen palpated. The right nare had no airflow, suggesting complete obstruction of the right nasal cavity. In order to betterevaluate, endoscopic and radiographic exams were performed. At the radiographic exam, in ventrodorsal projection, itwas observed an increase of volume and radiopacity, occupying the right antimer of the nasal cavity, with left nasal septum deviation. In the right dorsoventral oblique projection, it was observed the filling of the rostral and caudal maxillarysinus with the content radiopacity as previously described. At endoscopy exam of the right nasal cavity, it was observeda rounded greenish structure on the middle meatus The diagnosis of maxillary paranasal sinus cist was suggested andsurgical removal, through maxillary sinusotomy was recommended. During the surgical procedure...

Primary paranasal maxillary hematoma: clinical characteristics, diagnosis and surgical treatment

Background: The equine paranasal sinus have a complex anatomy and large compartiments. For this reason, deseasesthat affect these structures may develop for long periods before the animal show any clinical signs, making it difficult tostablish a definitive diagnosis and institute an adequate treatment. Usually, maxillary hematomas reports come from progression of ethmoidal hematomas, and the descriptions of primary maxillary hematomas are rare. This study aims to reportthe clinical features, diagnosis and treatment of a case of a maxillary hematoma not associated with ethmoidal turbinates.Case: An 8-year-old male horse, Mangalarga Paulista, was referred to the Centro de Apoio ao Ensino e Pesquisa FMVZUSP with history of nasal bleeding for over a year. The animal presented deformity on the right side of the face, with significant volume increase on the maxillary bone region and dull sound at percussion, in addition to great painfull sensibilitywhen palpated. The right nare had no airflow, suggesting complete obstruction of the right nasal cavity. In order to betterevaluate, endoscopic and radiographic exams were performed. At the radiographic exam, in ventrodorsal projection, itwas observed an increase of volume and radiopacity, occupying the right antimer of the nasal cavity, with left nasal septum deviation. In the right dorsoventral oblique projection, it was observed the filling of the rostral and caudal maxillarysinus with the content radiopacity as previously described. At endoscopy exam of the right nasal cavity, it was observeda rounded greenish structure on the middle meatus The diagnosis of maxillary paranasal sinus cist was suggested andsurgical removal, through maxillary sinusotomy was recommended. During the surgical procedure...(AU)

Cisto paranasal maxilar em equino: métodos diagnósticos e terapêuticos em descrição de caso / Maxilar paranasal cist in horse: case description of diagnostic and therapeutic metods / Quiste paranasal maxilar en equino: métodos diagnósticos y terapéuticos en la descripción del caso

Os cistos paranasais são formações sinusais comuns em equinos. Geralmente provocam deformação do crânio resultando em aumentos de volume facial e distorção das estruturas internas das cavidades nasal e paranasal. Este trabalho relata o caso de um equino acometido por um cisto paranasal, com longo tempo de evolução, causando grande deformação da face, das conchas nasais e alvéolos dentários. Foram descritos os achados dos exames odontológico, radiográfico, endoscópico e histopatológico utilizados para a conclusão do diagnóstico. O tratamento instituído foi a sinusotomia maxilar e retirada do cisto. O caso evoluiu positivamente, com completa remissão do cisto e melhora da qualidade de vida do paciente.

Paranasal cists are common lesions in horses. Usually causes skull deformations resulting in facial volume enlargments and nasal conchae deformations. This paper reports the case of a horse affected by paranasal cist, with long term evolution, causing large facial and nasal conchae deformity that reached dental alveolus. Findings of the oral cavity, radiographic, endoscopic and histopathological examinations used to conclude the diagnosis were described. The treatment was based on cyst removal trough maxillary sinusotomy. The case evolved positively, with complete cyst remission and improved quality of life.

Los quistes paranasales son una condición sinusal común en los equinos. Por lo general, causan la deformación del cráneo, lo que resulta en un aumento del volumen facial y Ia distorsión de las estructuras internas de las cavidades nasales y paranasales. Este trabajo reporta el caso de un equino afectado por un quiste paranasal, con un largo periodo de evolución, causando una gran deformación de la cara, conchas nasales, alcanzando los ápices dentales. Se describieron los hallazgos de los exámenes odontológicos, radiográficos, endoscópicos e histopatológicos, utilizados para concluir el diagnóstico. El tratamiento fue instaurado sinusotomía maxilar y extirpación del quiste. El caso evolucionó positivamente, con una remoción completa del quiste y una mejora de la calidad de vida del animal.

Cisto paranasal maxilar em equino: métodos diagnósticos e terapêuticos em descrição de caso / Maxilar paranasal cist in horse: case description of diagnostic and therapeutic metods / Quiste paranasal maxilar en equino: métodos diagnósticos y terapéuticos en la descripción del caso

Os cistos paranasais são formações sinusais comuns em equinos. Geralmente provocam deformação do crânio resultando em aumentos de volume facial e distorção das estruturas internas das cavidades nasal e paranasal. Este trabalho relata o caso de um equino acometido por um cisto paranasal, com longo tempo de evolução, causando grande deformação da face, das conchas nasais e alvéolos dentários. Foram descritos os achados dos exames odontológico, radiográfico, endoscópico e histopatológico utilizados para a conclusão do diagnóstico. O tratamento instituído foi a sinusotomia maxilar e retirada do cisto. O caso evoluiu positivamente, com completa remissão do cisto e melhora da qualidade de vida do paciente.(AU)

Paranasal cists are common lesions in horses. Usually causes skull deformations resulting in facial volume enlargments and nasal conchae deformations. This paper reports the case of a horse affected by paranasal cist, with long term evolution, causing large facial and nasal conchae deformity that reached dental alveolus. Findings of the oral cavity, radiographic, endoscopic and histopathological examinations used to conclude the diagnosis were described. The treatment was based on cyst removal trough maxillary sinusotomy. The case evolved positively, with complete cyst remission and improved quality of life.(AU)

Los quistes paranasales son una condición sinusal común en los equinos. Por lo general, causan la deformación del cráneo, lo que resulta en un aumento del volumen facial y Ia distorsión de las estructuras internas de las cavidades nasales y paranasales. Este trabajo reporta el caso de un equino afectado por un quiste paranasal, con un largo periodo de evolución, causando una gran deformación de la cara, conchas nasales, alcanzando los ápices dentales. Se describieron los hallazgos de los exámenes odontológicos, radiográficos, endoscópicos e histopatológicos, utilizados para concluir el diagnóstico. El tratamiento fue instaurado sinusotomía maxilar y extirpación del quiste. El caso evolucionó positivamente, con una remoción completa del quiste y una mejora de la calidad de vida del animal.(AU)

Study on the development of frontal sinuses by morphometric analysis of the skull / Estudo referente ao desenvolvimento dos seios frontais pela análise morfométrica do crânio

The frontal sinuses are cranial areas of clinical, forensic and pathology importance whose development mechanisms are still poorly defined. Nasal airflow and brain development are two of the main theories. Current analysis debates whether they are the real determinants of frontal sinuses growth, which may be proved by the skulls morphometric analysis. Four groups of measures related to the external cranial architecture, the pyriform aperture, orbital cavities and frontal sinuses were defined. Thirty-three skulls of individuals, mean age 68 years, from the Laboratory of Anatomy of the Academic Centre of Victoria UFPE Brazil, were used. Statistical analysis showed total agenesis of the frontal sinus in 18.2% of the skulls. There was significant correlation between the development of the right frontal sinus and the pyriform aperture, and between the left frontal sinus and two cranial measurements (p 0.05). Significant differences between mean of pyriform aperture areas of the skulls with or without sinuses were also reported (p 0.01). Results supported the fact that there was a modulation activity by nasal aeration and brain formation in the development of frontal sinuses.(AU)

Os seios frontais são espaços cranianos de importância clínica, forense e patológica, cujos mecanismos responsáveis pelo desenvolvimento são ainda pouco definidos, sendo duas das teorias propostas, o fluxo aéreo nasal e o desenvolvimento encefálico. Objetivou-se evidenciar por meio de análise morfométrica do crânio se estes são os reais fatores determinantes do crescimento dos seios frontais. Neste estudo, foram definidos quatro grupos de medidas referentes à arquitetura craniana externa, à abertura piriforme, às cavidades orbitárias e aos seios frontais. Para este propósito, nós utilizamos 33 crânios de indivíduos com média de idade de 68 anos, provenientes do Laboratório de Anatomia Humana Centro Acadêmico de Vitória- UFPE/Brasil. Após os exames estatísticos, foi verificado agenesia total dos seios frontais em 18,2 % dos crânios estudados. Houve correlação significativa entre o desenvolvimento do seio frontal direito e a abertura piriforme, e entre o do seio frontal esquerdo e duas aferições encefálicas, com p 0,05. Observamos uma diferença significativa entre as médias de áreas de abertura piriforme dos crânios que possuíam ou não os seios, com p 0,01. Os achados deste estudo comprovam o fato de que existe uma atividade moduladora exercida pela aeração nasal e formação encefálica no desenvolvimento dos seios frontais.(AU)