Surgical Debulking and TransEndoscopic Noncontact Diode Laser Application for Treating a Sinonasal Myxoma in a Horse.
Authors: Palozzo Adriana, Celani Gianluca, Varasano Vincenzo, Marruchella Giuseppe, Petrizzi Lucio
Journal: Journal of equine veterinary science
Summary
Sinonasal myxomas represent an exceptionally rare tumour type in horses, with limited documentation in the veterinary literature; this case report describes a novel combined approach to treatment in a 5-year-old gelding presenting with unilateral nasal discharge, facial swelling, and impaired airflow. Diagnostic imaging and endoscopy identified a pale, mass-like lesion within the right conchofrontal sinus that had caused significant deviation of the nasal septum, prompting a frontonasal bone flap approach under general anaesthesia for broad surgical excision followed by standing transendoscopic diode laser photoablation of residual tissue. Histopathological examination confirmed the benign diagnosis through identification of loosely arranged spindle cells within an abundant myxoid matrix, though the infiltrative nature of myxomas typically predisposes them to recurrence despite complete-appearing surgical removal. The combination of open surgical debulking with subsequent minimally invasive transendoscopic laser ablation yielded a positive clinical outcome through at least 14 months post-operatively, suggesting this multimodal approach may help mitigate recurrence risk in this challenging tumour type. For practitioners managing sinonasal masses, this case demonstrates the value of complementary surgical techniques in addressing benign but locally aggressive neoplasms, though longer-term follow-up data across multiple cases would be needed to establish this as standard protocol.
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Practical Takeaways
- •Sinonasal myxomas are rare in horses but should be considered in cases of unilateral nasal discharge, facial swelling, and decreased airflow; endoscopic and imaging evaluation are essential for diagnosis
- •Surgical excision alone is unlikely to prevent recurrence due to myxoma's infiltrative nature; combining surgery with transendoscopic laser ablation may improve long-term outcomes
- •This combined technique offers an alternative approach for managing benign sinonasal masses that may reduce need for repeated interventions
Key Findings
- •Equine sinonasal myxoma presented with serous nasal discharge, facial swelling, and decreased airflow in a 5-year-old gelding
- •Combined surgical debulking followed by transendoscopic diode laser photoablation successfully treated the myxoma with no recurrence at 14 months post-operatively
- •Histopathology confirmed benign myxoma with spindle-shaped cells in abundant myxoid matrix
- •Multimodal approach combining wide surgical excision with endoscopic laser ablation may reduce recurrence risk compared to surgery alone