Clinical and complementary diagnosis of sinus neoplasia in horses

Background: Sinus neoplasms are reported as low frequency in horses. Its clinical characteristics are often nonspecific, depend on complementary methods for diagnosis, and when diagnosed, generally they are already advanced, limiting therapeutic possibilities. The objective of this case series was to detail clinical aspects and complementary exams for sinus neoplasms for early diagnosis, comparing them with the literature. Cases: Four horses were treated at the College of Veterinary Medicine and Animal Science of the University of São Paulo, with different clinical signs and previous diagnoses, which when evaluated by respiratory endoscopy, radiography, oral cavity evaluation and histopathological exams, revealed the diagnosis of anaplastic carcinoma, poorly differentiated carcinoma, ossifying fibroma and lymphoma. Previous diagnosis, based mainly on clinical signs, were sinusitis secondary to apical infection, ethmoidal hematoma, sinus cyst and sinusitis secondary to periapical disease. The cases of anaplastic carcinoma (case 1) and lymphoma (case 4) presented with an advanced degree of the disease with involvement and destruction of paranasal structures and adjacent tissues, in addition to a poor general condition, which made surgical treatment impossible and led to euthanasia. In these cases, previous treatment was made to apical infection and periodontal disease with secondary sinusitis, but negative evolution led to suspicion of neoplasia, confirmed by histopathological exam of incisional biopsy of the mass in oral cavity. Benign ossifying fibroma (case 3) presented with progressive respiratory difficulty due to occlusion of the lumen of some nasal meatus and radiographic signs of invasion and deformation of the adjacent bones, it was submitted for surgical excision and there was no recurrence until hospital discharge. The poorly differentiated carcinoma (case 2) was a multilobulate neoformation in the ethmoidal region, similar to ethmoid hematoma in endoscopic and radiographic evaluation, it was submitted for excision and two sessions of electrochemotherapy with bleomycin, associated with administration of piroxicam, which obtained a good result until the period of 1 year after discharge. Discussion: It was found that many characteristics are common with these types of neoplasms, and the clinical signs, such as nasal secretions, airway obstruction, increased facial volume, severe alterations in oral cavity, although unspecific, suggest the differential diagnosis for neoplasms. It is important to differentiate from other diseases noting the evolution and growth of these tumors, like in cases 1 and 4, especially the growth to internal tissues, using complementary methods described here, like endoscopic and radiographic examination. Late identification or even manipulation of neoplasms, without proper diagnosis, leads to a few prognoses regarding life. When it is possible to perform surgical excision, complementary methods are important to guide the procedure, and definitive diagnosis is made through histopathologic exam and some need immunohistochemistry analysis. Cases 2 and 3 had surgical access, were submitted to excision and treatment with good results, both with close monitoring in first months and prolonged quality of life. These results highlight the importance of complementary methods for early diagnosis, correct intervention and monitoring of evolution.

Sinonasal osteosarcoma in a horse

Background: Osteosarcomas are common malignant bone tumors described in dogs, humans and cats. However, thereare rare reports in horses. The tumor etiology has not been fully elucidated. Clinical signs are associated to the tumorsize, location and growth characteristics. When located on the face, the most common findings are facial distortion, nasaldischarge and inspiratory dyspnea. The aim of this study was to report an osteoblastic osteosarcoma in a horse, located onthe right maxillary region with projections into the corresponding nostril.Case: A 6-year-old mixbreed saddle gelding, presenting bay coat was admitted to a University Hospital with a chronicsinusitis history. The animal was previously examined and treated by other veterinarians, who suspected of odontogenicmaxillary sinusitis, and therefore a repulsion of the fourth premolar from the right maxilla hemiarcade was performed.However, an improvement of the clinical signs was not observed and subsequently the gelding was referred to a VeterinaryHospital. During physical examination the patient presented dyspnea, tachypnea and tachycardia. An increase on the facesize was observed, together with a fetid and purulent nasal discharge. During oral cavity inspection, a diagonal wear wasdetected at the occlusal surface of the right hemiarcade; food accumulation was seen at the dental extraction site, and acommunication with the rostral maxillary sinus was evidenced, from where a purulent fetid discharge was draining. At theradiographic exam, well defined margins of a tumor were observed, with adjacent bone lysis and the presence of a centralnucleus showing a gross granular mineral radiopacity, distorting the frontal and nasal bones. During the endoscopic exam,a mass partially occluding the right nasal cavity close to the nasal opening was seen, which was blocking the progressionof the endoscopy. However, during the left cavity inspection, at the end of the nasal septum a mass...

Sinonasal osteosarcoma in a horse

Background: Osteosarcomas are common malignant bone tumors described in dogs, humans and cats. However, thereare rare reports in horses. The tumor etiology has not been fully elucidated. Clinical signs are associated to the tumorsize, location and growth characteristics. When located on the face, the most common findings are facial distortion, nasaldischarge and inspiratory dyspnea. The aim of this study was to report an osteoblastic osteosarcoma in a horse, located onthe right maxillary region with projections into the corresponding nostril.Case: A 6-year-old mixbreed saddle gelding, presenting bay coat was admitted to a University Hospital with a chronicsinusitis history. The animal was previously examined and treated by other veterinarians, who suspected of odontogenicmaxillary sinusitis, and therefore a repulsion of the fourth premolar from the right maxilla hemiarcade was performed.However, an improvement of the clinical signs was not observed and subsequently the gelding was referred to a VeterinaryHospital. During physical examination the patient presented dyspnea, tachypnea and tachycardia. An increase on the facesize was observed, together with a fetid and purulent nasal discharge. During oral cavity inspection, a diagonal wear wasdetected at the occlusal surface of the right hemiarcade; food accumulation was seen at the dental extraction site, and acommunication with the rostral maxillary sinus was evidenced, from where a purulent fetid discharge was draining. At theradiographic exam, well defined margins of a tumor were observed, with adjacent bone lysis and the presence of a centralnucleus showing a gross granular mineral radiopacity, distorting the frontal and nasal bones. During the endoscopic exam,a mass partially occluding the right nasal cavity close to the nasal opening was seen, which was blocking the progressionof the endoscopy. However, during the left cavity inspection, at the end of the nasal septum a mass...(AU)

Sinoscopia como método de diagnóstico e tratamento de sinusite pós-traumática em equíno / Synoscopy as a diagnostic method and treatment of post-traumatic synusitis in equin

Um cavalo de 6 anos apresentou secreção nasal unilateral e forte odor associado ao baixo desempenho atlético. Após avaliação clínica e exames de sinoscopia, confirmou-se sinusite primária, com grande quantidade de conteúdo purulento de muco nos seios paranasais esquerdos, além de fratura no osso nasal, sendo a possível causa da patologia. Com o auxílio do endoscópio e uma sonda de Foley, foram realizadas lavagens para remover o conteúdo, associando antibiótico com mucolítico diluído no soro. Como tratamento pós-operatório, foi formulada antibioticoterapia sistêmica, bem como lavagens diárias através da sonda com a mesma solução utilizada na cirurgia.(AU)

A 6-year-old horse presented unilateral nasal discharge and strong odor associated with poor athletic performance. After clinical evaluation and exams of sinoscopy, a primary sinusitis was confirmed, with a large amount of mucus-purulent content in the left paranasal sinuses, as well as a fracture in the nasal bone, being the possible cause of the pathology. With the aid of the endoscope and a Foley probe, washes were performed to remove the contents, associating antibiotic with mucolytic diluted in serum. As postoperative treatment a systemic antibiotic therapy was formulated, as well as daily washes through the probe with the same solution used in the surgery.(AU)

Exodontia bilateral em equino com doença periapical e cárie / Bilateral exodontia in horses with periapical disease and caries

A odontologia equina é uma especialidade crescente no Brasil, porém sua importância ainda é negligenciada pelos proprietários e alguns veterinários. O objetivo deste estudo foi analisar um caso de sinusite unilateral por doença periapical de 1º molar eqüino. Nester elato, uma descarga nasal unilateral esquerda eqüina foi analisada há 30 dias, durante o exame radiográfico, foi possível observar a presença de pus no seio maxilar rostral, acimado dente comprometido 209, e a extração do dente comprometida e o dente contralateral também comprometido. O tratamento pós-operatório baseou-se na lavagem da boca do cavalo com água corrente, na aplicação de mel de abelha com extrato de própolis, na administração de anti-inflamatórios e antibióticos, proporcionando excelente recuperação e remissão cirúrgica e pós-operatória. sinais clínicos totais observados.(AU)

Equine dentistry is a growing specialty in Brazil, however its importance is still of ten overlooked by owners and some veterinarians. The objective of this study was to analyze a case of unilateral sinusitis due to equine 1st molar periapical disease. In this report, an equine left unilateral nasal discharge was analyzed 30 days ago, during the radiographic examination, it was possible to observe the presence of pus within the rostral maxillary sinus, above the compromised tooth 209, and the extraction of the tooth compromised and the contralateral tooth also compromised. The postoperative treatment was based on washing the horse's mouth with running water, applying bee honey with propolis extract,as well as administering anti-inflammatory and antibiotics, providing excellent surgical and postoperative recovery and remission. total clinical signs observed.(AU)

Sinoscopia como método de diagnóstico e tratamento de sinusite pós-traumática em equino / Synoscopy as a diagnostic method and treatment of post-traumatic synusitis in equin

Um cavalo de 6 anos apresentou secreção nasal unilateral e forte odor associado ao baixo desempenho atlético. Após avaliação clínica e exames de sinoscopia, confirmou-se sinusite primária, com grande quantidade de conteúdo purulento de muco nos seios paranasais esquerdos, além de fratura no osso nasal, sendo a possível causa da patologia. Com o auxílio do endoscópio e uma sonda de Foley, foram realizadas lavagens para remover o conteúdo, associando antibiótico com mucolítico diluído no soro. Como tratamento pós-operatório, foi formulada antibioticoterapia sistêmica, bem como lavagens diárias através da sonda com a mesma solução utilizada na cirurgia.

A 6-year-old horse presented unilateral nasal discharge and strong odor associated with poor athletic performance. After clinical evaluation and exams of sinoscopy, a primary sinusitis was confirmed, with a large amount of mucus-purulent content in the left paranasal sinuses, as well as a fracture in the nasal bone, being the possible cause of the pathology. With the aid of the endoscope and a Foley probe, washes were performed to remove the contents, associating antibiotic with mucolytic diluted in serum. As postoperative treatment a systemic antibiotic therapy was formulated, as well as daily washes through the probe with the same solution used in the surgery.

Exodontia bilateral em equino com doença periapical e cárie / Bilateral Exodontia In Horses With Periapical Disease And Caries

A odontologia equina é uma especialidade crescente no Brasil, porém sua importância ainda é negligenciada pelos proprietários e alguns veterinários. O objetivo deste estudo foi analisar um caso de sinusite unilateral por doença periapical de 1º molar eqüino. Neste relato, uma descarga nasal unilateral esquerda eqüina foi analisada há 30 dias, durante o exame radiográfico, foi possível observar a presença de pus no seio maxilar rostral, acima do dente comprometido 209, e a extração do dente comprometida e o dente contralateral também comprometido. O tratamento pós-operatório baseou-se na lavagem da boca do cavalo com água corrente, na aplicação de mel de abelha com extrato de própolis, na administração de anti-inflamatórios e antibióticos, proporcionando excelente recuperação e remissão cirúrgica e pós-operatória. sinais clínicos totais observados.

Equine dentistry is a growing specialty in Brazil, however its importance is still often overlooked by owners and some veterinarians. The objective of this study was to analyze a case of unilateral sinusitis due to equine 1st molar periapical disease. In this report, an equine left unilateral nasal discharge was analyzed 30 days ago, during the radiographic examination, it was possible to observe the presence of pus within the rostral maxillary sinus, above the compromised tooth 209, and the extraction of the tooth compromised and the contralateral tooth also compromised. The postoperative treatment was based on washing the horse's mouth with running water, applying bee honey with propolis extract, as well as administering anti-inflammatory and antibiotics, providing excellent surgical and postoperative recovery and remission. total clinical signs observed.

Sinusite crônica em Cyanoloxia brissonii / Chronic sinusitis in Cyanoloxia brissonii

A Ultramarine Grosbeak (Cyanoloxia brissonii) was treated at the Veterinary Hospital Dr. Jerônimo Dix-Huit Rosado Maia - HOVET UFERSA with complaint of respiratory alterations, the animal arrived dyspneic and with a marked increase of the left nostril. For the treatment of sinusitis, antibiotic (Enrofloxacin -15mg/kg, once daily (SID) for 7 days), anti-inflammatory (Cetoprofen - 2mg/kg, SID, for 5 days), both orally, and nebulization (Gentamicin -5mg/kg associated with Aminophylline - 1mL/10mL of Physiological Solution, twice a day (BID), throughout the treatment period). Removal of the cushion was carried out in the left nostril, which showed recurrence and the need for two new cleanings of this nostril. On the third occasion, the chemical cauterization with 2% iodine and the addition of a ciprofloxacin-based eye drops to be made via topical in the nostril, thus obtaining success in the treatment.

Sinusite crônica em Cyanoloxia brissonii / Chronic sinusitis in Cyanoloxia brissonii

A Ultramarine Grosbeak (Cyanoloxia brissonii) was treated at the Veterinary Hospital Dr. Jerônimo Dix-Huit Rosado Maia - HOVET UFERSA with complaint of respiratory alterations, the animal arrived dyspneic and with a marked increase of the left nostril. For the treatment of sinusitis, antibiotic (Enrofloxacin -15mg/kg, once daily (SID) for 7 days), anti-inflammatory (Cetoprofen - 2mg/kg, SID, for 5 days), both orally, and nebulization (Gentamicin -5mg/kg associated with Aminophylline - 1mL/10mL of Physiological Solution, twice a day (BID), throughout the treatment period). Removal of the cushion was carried out in the left nostril, which showed recurrence and the need for two new cleanings of this nostril. On the third occasion, the chemical cauterization with 2% iodine and the addition of a ciprofloxacin-based eye drops to be made via topical in the nostril, thus obtaining success in the treatment.(AU)

Comparison between three techniques for videosinuscopy in cattle / Comparação entre três técnicas para videosinuscopia em bovinos

Cattle have extensive paranasal sinuses that are susceptible to disease, most commonly sinusitis. The sinuscopy can be used to evaluate these structures, although there are no descriptions of this region for endoscopic anatomy, especially regarding the trocar position and the most appropriate type of endoscope. This study aimed to standardize the surgical approaches to sinuscopy in cattle by comparing the use of three endoscopes. Four accesses by trephination (one hole for each of the maxillary and frontal sinuses) were made in eight heads of slaughtered cattle. Each hole was inspected with three endoscopes: a 10mm flexible colonoscope with up to 180º of angulation, a 10mm 0° laparoscope and a 4mm 30º arthroscope. It was observed that all regions of the maxillary sinus were better visualized with the 4mm endoscope, and the structures of this sinus were less well visualized with the 10mm laparoscope. The frontal sinus was difficult to evaluate due to the tortuosity of its bony projections, and the cranial portion was not observed by the proposed accesses. The caudal regions of the frontal sinus such as the nuchal diverticulum and the back of the orbit had the greatest number of structures visualized by the 4mm endoscope, followed by the colonoscope. The comparative analysis showed that the 4mm endoscope was most efficient and could be adapted to sinuscopy in cattle.(AU)

Os bovinos apresentam seios paranasais extensos e passíveis de afecções, como a sinusite. A sinuscopia, técnica já utilizada em outras espécies, avalia os seios paranasais de modo pouco invasivo e não é descrita em bovinos. O presente estudo objetivou padronizar os acessos cirúrgicos para sinuscopia em bovinos, testando três técnicas de videoendoscopia. Foram selecionadas oito cabeças de bovinos provenientes de abatedouro comercial, sendo realizada a trepanação dos seios maxilares e frontais de ambos os lados (um orifício por seio). Cada seio foi inspecionado com três óticas: um colonoscópio flexível com 10mm de diâmetro e até 180º de angulação, um laparoscópio rígido de 10mm e 0º e um artroscópio rígido de 4mm e 30º. Na região caudal do seio maxilar, os alvéolos e abertura maxilopalatina foram visualizadas com todas as óticas. A região caudodorsomedial e rostral do seio maxilar foram observadas com a ótica flexível e a rígida de 4mm, sendo que apenas esta adentrou no seio palatino. O seio frontal é de difícil visualização, devido à tortuosidade de suas projeções ósseas e sua porção cranial não foi observada pelo acesso proposto. A região caudal do seio frontal, o divertículo nucal e a área caudal à órbita tiveram o maior número de estruturas visualizadas com a ótica rígida de 4mm, seguida da flexível. A análise comparativa demonstra que a técnica utilizando a ótica rígida de 4mm permite a visualização de um maior número de estruturas com maior detalhamento e é a que mais se adapta à sinuscopia em bovinos.(AU)

Expression of RANTES, eotaxin-2, ICAM-1, LFA-1 and CCR-3 in chronic rhinosinusitis patients with nasal polyposis / Expressão de RANTES, eotaxina-2, ICAM-1, LFA-1 e CCR-3 em pacientes com rinossinusite crônica associada à polipose nasossinusal

PURPOSE: To compare gene expression of the chemokines RANTES and eotaxin-2, its receptor, CCR-3, adhesion molecule ICAM-1 and its receptor LFA-1 in eosinophilic polyps and in control normal nasal mucosa. METHODS: Gene expression was quantified by Real Time PCR in polyps (n=35) and in healthy nasal mucosa (n=15). RESULTS: Eosinophilic polyps showed a higher expression of eotaxin-2 and RANTES, but not of CCR-3, ICAM-1 or LFA-1 compared to control nasal mucosa. CONCLUSION: Eosinophilic polyps present greater expression of eotaxin-2 and RANTES, but not of CCR-3, ICAM-1 or LFA-1 compared to control nasal mucosa.(AU)

OBJETIVO: Comparar a expressão gênica das quimiocinas RANTES e eotaxina-2, do seu receptor CCR-3, da molécula de adesão ICAM-1 e do seu receptor LFA-1 entre pólipos nasais eosinofílicos (PE) (n=35) e mucosa nasal controle (n=15). MÉTODOS: Quantificou-se a expressão gênica dos mediadores citados pela técnica de PCR em tempo real em PEs e em mucosas de concha média de pacientes sem doenças nasais ou alteração endoscópica. RESULTADOS: Pólipos eosinofílicos apresentam maior expressão de eotaxina-2 e RANTES, mas não de CCR-3, ICAM-1 e LFA-1, quando comparados as mucosas nasais controles. CONCLUSÃO: Pólipos eosinofícios apresentaram maior expressão de eotaxin-2 and RANTES, mas não de CCR-3, ICAM-1 ou LFA-1,comparada à mucosa nasal controle.(AU)

Avaliação radiográfica e tomográfica dos seios nasais de gatos com doenças sinonasais crônicas / Radiographic and tomographic evaluation of nasal sinus in ten cats with chronic sinonasal diseases

Avaliaram-se os seios nasais de 10 gatos mestiços, adultos, acometidos por afecções sinonasais, por meio de exames radiográfico e tomográfico, e descreveram-se as vantagens e desvantagens dos métodos. O grande diferencial do exame de tomografia computadorizada em relação ao exame radiográfico, na avaliação dos seios nasais, foi a detecção de alterações nos seios esfenoides e a maior facilidade em localizar a lateralidade e o grau de envolvimento de alterações dos seios frontais.(AU)

The purpose of this study was to evaluate the nasal sinus of ten adult mixed-breed cats with sinonasal diseases, using radiography and computed tomography to describe the advantages and disadvantages of the methods. In the evaluation of the nasal sinus, the advantages of the CT examination regarding the radiography had been the detection of alterations in the sphenoid sinus and the easiness in locating the side affected and the degree of involvement of the frontal sinus.(AU)

Avaliação de quatro protocolos terapêuticos para a sinusite pós-descorna plástica em bovinos / Evaluation of four treatment protocols to sinusitis after plastic dehornig in cattle

A descorna plástica em bovinos adultos pode resultar em diversas complicações trans e pós-operatórias. Uma das possíveis sequelas deste procedimento é a sinusite, um processo inflamatório que acomete os seios paranasais, como consequência da exposição do seio frontal. No presente estudo, avaliou-se a eficácia de protocolos terapêuticos contendo hipoclorito de sódio, policresuleno, iodopovidona e solução isotônica de cloreto de sódio no tratamento da sinusite pósdescorna em 60 bovinos, distribuídos em quatro grupos experimentais de 15 animais, GI, GII, GIII e GIV. Durante o acesso ao seio frontal para proceder ao tratamento local, atentou-se para a presença de corpos estranhos, sendo observadas esquírolas ósseas, hastes de capim, fios de sutura e farpas de madeira. O escoamento da secreção mucopurulenta e a remoção do excesso de soluções empregadas no local infectado foi facilitada, girando a cabeça do animal e posicionando a abertura do seio frontal o mais ventralmente possível. Empregando o teste do Qui-quadrado, observou-se diferença significativa entre os tratamentos. O hipoclorito de sódio e a iodopovidona foram os tratamentos mais eficazes, podendo ser recomendados no tratamento desta enfermidade.

Plastic dehornig in adult cattle can result in several trans and postoperative complications. Sinusitis is an important sequela, resulting from an inflammatory process affecting the exposed frontal sinuses. In the present study, treatment protocols efficacy was evaluated in 60 bovines. Therapeutic protocols included sodium hypochlorite, policresulen, povidone-iodine and isotonic sodium chloride solution, which were divided into four experimental groups of 15 animals, GI, GII, GIII and GIV. During frontal sinus access to institute local treatment, attempts to identify foreign bodies, bone fragments, grass stems, suture material and wood splints were made. Mucous-purulent liquid drainage and excess solutions removal were facilitated by laterally rotating the animal’s head and placing the frontal sinus gap as ventral as possible. Using chi-square test, there was significant difference between treatments. Sodium hypochlorite and povidone-iodine were the most effective treatments, being recommended as part of sinusitis therapeutic protocol.

Avaliação de quatro protocolos terapêuticos para a sinusite pós-descorna plástica em bovinos / Evaluation of four treatment protocols to sinusitis after plastic dehornig in cattle

A descorna plástica em bovinos adultos pode resultar em diversas complicações trans e pós-operatórias. Uma das possíveis sequelas deste procedimento é a sinusite, um processo inflamatório que acomete os seios paranasais, como consequência da exposição do seio frontal. No presente estudo, avaliou-se a eficácia de protocolos terapêuticos contendo hipoclorito de sódio, policresuleno, iodopovidona e solução isotônica de cloreto de sódio no tratamento da sinusite pósdescorna em 60 bovinos, distribuídos em quatro grupos experimentais de 15 animais, GI, GII, GIII e GIV. Durante o acesso ao seio frontal para proceder ao tratamento local, atentou-se para a presença de corpos estranhos, sendo observadas esquírolas ósseas, hastes de capim, fios de sutura e farpas de madeira. O escoamento da secreção mucopurulenta e a remoção do excesso de soluções empregadas no local infectado foi facilitada, girando a cabeça do animal e posicionando a abertura do seio frontal o mais ventralmente possível. Empregando o teste do Qui-quadrado, observou-se diferença significativa entre os tratamentos. O hipoclorito de sódio e a iodopovidona foram os tratamentos mais eficazes, podendo ser recomendados no tratamento desta enfermidade.(AU)

Plastic dehornig in adult cattle can result in several trans and postoperative complications. Sinusitis is an important sequela, resulting from an inflammatory process affecting the exposed frontal sinuses. In the present study, treatment protocols efficacy was evaluated in 60 bovines. Therapeutic protocols included sodium hypochlorite, policresulen, povidone-iodine and isotonic sodium chloride solution, which were divided into four experimental groups of 15 animals, GI, GII, GIII and GIV. During frontal sinus access to institute local treatment, attempts to identify foreign bodies, bone fragments, grass stems, suture material and wood splints were made. Mucous-purulent liquid drainage and excess solutions removal were facilitated by laterally rotating the animals head and placing the frontal sinus gap as ventral as possible. Using chi-square test, there was significant difference between treatments. Sodium hypochlorite and povidone-iodine were the most effective treatments, being recommended as part of sinusitis therapeutic protocol.(AU)