Regional Veterinary Surgery

Necrosis of the turbinate bone

NECROSIS OF TURBINATE BONES

Incidence

• It occurs occasionally in the horse but rarely in other species.

Etiology

• The lesion is generally due to strangles, with an accumulation of pus in the folds of the bones.
• Wound inflicted directly through the nostril or through the nasal bones followed by infection of the seat of injury.
• It may be a complication of the root of a molar tooth in its vicinity.

Symptoms

• Foetid purulent discharge, usually unilateral interference with respiration, manifested by a snuffling or roaring noise
• Swelling in the nasal chamber, which may or may not be visible or palpable from nostril
• Ulceration and discoloration of the bone which may be felt by fingers
• Dullness on percussion of the affected region and swelling of the submaxillary lymphatic glands.

Prognosis

• Favourable when the necrotic portion can be entirely removed

Treatment

•  Medical management not much effective

Surgical treatment

Anaesthesia

• Block the maxillary nerve and sedate the patient if necessary. It is also best to perform a tracheotomy.

Operation procedure

• Make a trephine opening where the nasal bones start to diverge and far enough from the median line to avoid injury to the nasal septum.
• Cut the cartilaginous anterior end of the turbinate loose from its attachments anteriorly and with a nasal septum chisel cut the attachment.
• Bleeding can be controlled by tamponing the cavity tightly with gauze. It is impossible to completely remove the ventral turbinate due to its anatomical location.
• After operation, the affected region may be insufflated with iodoform powder or a mixture of it and boric acid once daily as a further antiseptic precaution.