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Pneumocephalus secondary to removal of an osteoma from the paranasal sinuses of a horse

Claude A. Ragle DVM, DACVS, DABVP1, Monica C. de Mira Med Vet2, Lisa K. Pearson DVM3, and Joana C. Coelho Med Vet4
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  • 1 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164.
  • | 2 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164.
  • | 3 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164.
  • | 4 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164.

Abstract

Case Description—A 2-year-old Quarter Horse was evaluated because of a progressive left-sided facial deformity and unilateral nasal and ocular discharge.

Clinical Findings—Physical examination revealed convexity of the left frontonasal region, left-sided nasal and ocular discharge, and decreased air flow through the left nares. Radiography and computed tomography revealed an extensively mineralized mass occupying most of the left paranasal sinuses.

Treatment and Outcome—The mass was surgically debulked, but complete removal was precluded because the mass was tightly adhered to the frontal and maxillary bones. Results of histologic examination of the mass were consistent with a diagnosis of osteoma. The horse developed transient pyrexia and colic following surgery, and postoperative radiography revealed gas opacities in the lateral ventricles of the brain, consistent with iatrogenic pneumocephalus. However, the horse did not develop any neurologic signs and was performing normally 2 years after surgery.

Clinical Relevance—Findings reinforce concerns that paranasal sinus surgery in horses can be associated with intracranial complications such as pneumocephalus. In horses with a mass involving the paranasal sinuses, computed tomography may be helpful in determining the boundaries of the mass and formulating a surgical treatment plan.

Contributor Notes

Dr. de Mira's present address is Hospital Veterinario, Universidade de Evora, Evora, Portugal.

Dr. Pearson's present address is Equine Medical Center of Ocala, 7107 W Hwy 326, Ocala, FL 34482.

Dr. Coelho's present address is Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824.

Address correspondence to Dr. Pearson.