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Vet Surg. 2019 Apr 9. doi: 10.1111/vsu.13207. [Epub ahead of print]

Surgical enlargement of the nasomaxillary aperture and transnasal conchotomy of the ventral conchal sinus: Two surgical techniques to improve sinus drainage in horses.

Author information

1
Equine University Clinic, University of Veterinary Medicine, Vienna, Austria.
2
Clinical Unit of Diagnostic Imaging, University of Veterinary Medicine, Vienna, Austria.
3
VetCore Facility for Research, University of Veterinary Medicine, Vienna, Austria.

Abstract

OBJECTIVE:

To evaluate 2 surgical techniques for establishing and/or improving paranasal sinus drainage in cadaver heads and horses with sinusitis and evaluate the feasibility of postoperative transnasal sinus endoscopy.

STUDY DESIGN:

Ex vivo study (equine cadaver heads) and case series.

SAMPLE POPULATION:

Nine adult equine cadaver heads and 8 horses with recurrent sinusitis.

METHODS:

For the ex vivo study, the following procedures were performed on 9 cadaver heads: preoperative and postoperative computed tomography (heads 1-6), endoscopy-guided transnasal conchotomy of the ventral conchal sinus (TCVCS) and surgical enlargement of the nasomaxillary aperture (SENMAP) on opposite sides (heads 1-3), combined TCVCS and SENMAP on both sides (heads 4-9), evaluation of sinus drainage before and after surgery (heads 7-9), and postoperative transnasal endoscopy (heads 4-9). For the case series, 8 horses with secondary sinusitis were treated in standing position with SENMAP and/or TCVCS and postoperative transnasal endoscopy.

RESULTS:

Sinonasal communications were successfully created in all cadavers and affected live horses. Transnasal endoscopy of all sinuses except the middle conchal sinus was possible in heads 4-9 and in all clinical cases. Sinus drainage was improved (P = .028) by combining techniques. Blood loss in live horses ranged from 0.5-5.5 L (1.95 ± 1.5) per horse. Sinusitis resolved in all affected horses during follow-up of 3.2-25.5 months (13.5 ± 8.5).

CONCLUSION:

Transnasal conchotomy of the ventral conchal sinus and SENMAP consistently created large sinonasal communications, facilitating sinus endoscopy and improving sinus drainage.

CLINICAL SIGNIFICANCE:

Transnasal conchotomy of the ventral conchal sinus and SENMAP are viable options to treat horses with sinusitis and anatomical obstructions of the sinonasal communications.

PMID:
30968454
DOI:
10.1111/vsu.13207

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