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

ABSTRACT

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...