Standing surgical removal of a progressive ethmoidal haematoma invading the sphenopalatine sinuses in a horse

Summary

Progressive ethmoidal haematomas represent a significant diagnostic and surgical challenge in equine practice, particularly when lesions extend beyond the ethmoidal turbinates into adjacent paranasal sinuses such as the sphenopalatine. Smith and Perkins present a clinical case managed via standing surgical removal, utilising computed tomography to define the precise boundaries of an invasive mass—an imaging advantage over conventional radiography that substantially improved surgical planning and execution. The case demonstrates that CT imaging provides critical three-dimensional anatomical information for lesions breaching normal sinus compartments, enabling more targeted and potentially less destructive surgical approaches than blind or radiographically-guided procedures. For practitioners managing horses with progressive nasal discharge, epistaxis, or facial swelling, this report underscores the diagnostic value of advanced imaging when standard radiographs suggest sinusitis or mass effect, particularly before committing to invasive surgery. The successful standing approach adds to the evidence base for minimally invasive techniques in sinus pathology, potentially offering reduced morbidity compared to traditional surgical access methods.

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Key Findings

• •Progressive ethmoidal haematoma successfully removed via standing surgical approach with invasion into sphenopalatine sinus
• •CT imaging provided superior visualization of haematoma extent compared to plain radiography for surgical planning
• •Standing surgical technique enabled successful treatment without general anaesthesia

Conditions Studied