NEOPLASMS IN THE HORSE’S NOSE.
Nasal fibrous polypus, connection, form, size, bony distortion, obstructed breathing, abrasion, ulceration, sloughing, submucous polypus, structure, degeneration. Symptoms, sneezing, snuffling, discharge, palpation, bony swelling, tenderness. Treatment, forceps, hook, ecraseur, knife, saw. Actinomycosis. Sarcoma, Carcinoma. Consistency, structure, fœtor, glandular swelling. Treatment. Recurrence. Fatty tumors. Bony tumors: cancellated or compact tissue, localized or extended. Cysts. Strongyli. Angioma. Varicosity. Color, obstruction to breathing, hæmorrhage, cicatrization.
These are essentially surgical diseases yet as they induce Chronic Catarrh they may be profitably noticed here.
I. Fibrous Nasal Polypus. These are connected to the mucosa by a pedicle or broad base, and vary in size from a pea to a mass which fills the entire nasal chamber, projects from the nostrils and presses outward the septum and facial bones. At times they weigh one or more pounds. They may cause whistling or rattling in breathing, or may completely obstruct the passage of air on the affected side. In time they may cause bulging or even attenuation and perforation of the bony walls, projecting through the hard palate or on the face. Sometimes the surface becomes the seat of granulation, ulceration, or sloughing, causing more or less fœtor. The large polypi make their main growth forward and backward, moulding themselves to the form of the chamber, and displacing the turbinated bones. They commence to grow under the mucous membrane and as they grow and become more loosely attached they carry this as an outer covering and pedicle. When incised they show a structure of interlacing bundles of fibres, with cell elements more or less abundant, according to the rapidity of growth. Gravitz found amyloid degeneration of the walls of the blood vessels and mucous follicles and of the fibres.
Symptoms are difficult breathing, snuffling, a smaller current of air on the affected side, or none, sneezing, a watery, purulent, bloody, or fœtid discharge, and the appearance of the polypus when the nasal chamber is examined in a good light. If beyond reach of vision the polypus may often be felt by the finger. Care must be taken not to mistake the red, angry surface of the turbinated bones in Catarrh for a polypus. If beyond the reach of the finger, the flat sound on percussion of the nasal and frontal bones on the affected side, and the persistently diminished flow of air may serve for diagnosis. Tenderness shown on percussion is common to this and abscess of the sinuses.
Treatment. The horse having been cast with the diseased side uppermost and the head turned to the light, the tumor is seized with the fingers, the forceps, or hook, and drawn gently outward. The chain of the ecraseur may be passed over it and slowly tightened upon the pedicle until it is cut through. This will usually obviate any laceration of the turbinated bones and consequent bleeding. In case of serious hæmorrhage check by cold water, ice, the actual cautery, or by plugging. Polypi with a broad base may be removed with a prob-pointed knife, curved on the flat, and furnished with a long handle. The mass is seized with a vulsella and detachment made by passing the knife with the concave side toward the tumor. In cases where the tumor cannot be seen or reached some have resorted to slitting up the outer wall of the nostril as far as the angle of union of the nasal and maxillary bones, care being taken to make the incision outside the upper end of the cartilage of the ala nasi. If too high to be satisfactorily reached in this way the nasal or frontal bone may be trephined over the body of the tumor as indicated by the flatness on percussion, and the operation performed through the opening thus made.
II. Actinomycosis. Though much more common in cattle than horses, yet the occasional occurrence of this in the face of the solipede must not pass unnoticed.
III. Sarcoma and Carcinoma. These are found growing from the periosteum, or even starting in the cancellated tissue and projecting into the nose, where they give rise to symptoms like those of fibrous polypi. Being much softer in texture and more liable to ulceration and degeneration they are likely to cause a much more offensive discharge. There is also more tendency to the implication of the submaxillary lymphatic glands. The only treatment is surgical and recurrence is always to be feared. (See Diseases of the Orbit.)
IV. Fatty Tumors of the nose are described by Röll and Gurlt as existing on the septum and in the sinuses. Being simple, they can be removed with great confidence as to nonrecurrence.
V. Osseous Tumors of the Nasal walls. These are described by Röll as osteophytes in the maxillary sinus in chronic catarrh, and by Gamgee as osteomata attached to the outer wall of the nasal chamber, which had to be detached by saw and bone forceps. I have found these latter of a soft porous structure easily detached by the knife, and in other cases dense and requiring, chisel, saw and forceps. In one instance the tumor grew from a dense hypertrophy of the maxillary bone which could not be entirely removed because the molar alveoli were implicated.
VI. Cysts named by Röll and others as present in the mucosa of the ethmoid cells in solipedes often contain larva of the strongylus armatus.
VII. Angioma may be but an exaggerated development of the abundant venous plexus and erectile tissue on the surface of the turbinated bones. There appears to be at other times an actual increase of the vascular tissue. As might be expected it has no abrupt margin, but gradually shades off into the healthy tissue. The prominent centre has a bluish red or brownish hue. It obstructs breathing, is apt to bleed under violent exertions in draught, or in contested races, and readily ulcerates with a bloody discharge. If it subsides and heals, it is followed by a whitish puckering like the so-called cicatrix of glanders.