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Topic:Minimally Invasive Surgery

Minimally invasive surgery (MIS) in horses refers to surgical techniques that limit the size and number of incisions needed to perform procedures. These techniques often involve the use of specialized equipment such as endoscopes, cameras, and instruments designed for precision. MIS aims to reduce tissue trauma, potentially leading to shorter recovery times and decreased post-operative discomfort compared to traditional surgical methods. Common minimally invasive procedures in equine medicine include arthroscopy, laparoscopy, and thoracoscopy, which are used for diagnostic and therapeutic purposes. This page compiles peer-reviewed research studies and scholarly articles that explore the methodologies, applications, and outcomes of minimally invasive surgery in equine practice.
Surgical Removal of a Large Maxillary Sinus Mass Containing Three Dental Structures in a Standing Horse.
Journal of veterinary dentistry    January 9, 2026   8987564251407977 doi: 10.1177/08987564251407977
de Chaisemartin C, Belluco S, Nottrott K.Dental masses such as odontogenic masses, heterotopic polydontia, or ectopic supernumerary teeth have been documented in the equine head. This is the first case report of a large maxillary sinus mass with 3 ectopic teeth in an adult horse. A 14-year-old warmblood gelding was presented for evaluation of chronic right-sided nasal discharge. After imaging exploration, surgery was performed on the standing horse with a conchofrontal sinus trephination and a large maxillary bone (MB) sinusotomy. The examinations revealed a sinusal mass in the right maxillary sinus covered by sinusal mucosa and surr...
Correction: An anatomical study of the subarachnoid space surrounding the trigeminal ganglion in horses-in preparation for a controlled glycerol rhizotomy in equids.
Frontiers in veterinary science    December 15, 2025   Volume 12 1749889 doi: 10.3389/fvets.2025.1749889
Becker R, Haenssgen K, Precht C, Khoma OZ, Hlushchuk R, Koch C, Kaessmeyer S, de Preux M.[This corrects the article DOI: 10.3389/fvets.2024.1424890.].
Full-laparoscopic nephrosplenic space closure with barbed knotless sutures in horses with left dorsal colon displacement without previous colon repositioning.
The Veterinary record    December 4, 2025   doi: 10.1002/vetr.6013
Willems T, Dias ABM, Dedecker L, Matamalas SS, De Lange L, de Beauregard T.Nephrosplenic space entrapment (NSE) has reported recurrence rates of 8%‒23%, and closure of the nephrosplenic space (NSS) has been shown to lower the incidence. Described techniques for nephrosplenic space closure (NSC) with concurrent left dorsal displacement (LDD) of the colon at the time of surgery consist of reducing the displaced colon prior to closure. Methods: A retrospective study was performed to evaluate the medical records of horse undergoing NSC between 2017 and 2024. A total of 18 horses with LDD at time of NSC and 21 without displacement at time of NSC were evaluated. Short- a...
Use of a Fogarty balloon catheter for management of distal nasolacrimal duct atresia in a standing sedated horse.
The Canadian veterinary journal = La revue veterinaire canadienne    December 1, 2025   Volume 66, Issue 12 1273-1278 
Bourassi S, Jack H, Florczyk A.A 4-year-old Arabian cross paint mare was referred for evaluation of chronic mucopurulent discharge and epiphora of the left eye. Ophthalmic and radiographic evaluations confirmed distal nasolacrimal duct atresia with absence of the nasolacrimal orifice. Initial minimally invasive treatments, including guidewire-assisted catheterization and diode laser photoablation, were unsuccessful. Definitive treatment was achieved using a Fogarty arterial embolectomy catheter under standing sedation. Controlled balloon inflation and deflation enabled progressive dilation of the obstructed duct, and a surg...
Endoscopically assisted transcutaneous placement of a balloon catheter in the medial guttural pouch compartment of the horse: A surgical approach to local treatment.
Veterinary surgery : VS    November 20, 2025   Volume 55, Issue 1 131-141 doi: 10.1111/vsu.70059
Lepage H, de Chaisemartin C, Spadaro Rosselo A, Leroy H, Lepage O.To describe and report clinical outcomes after transcutaneous guttural pouch (GP) catheterization (TGPC) in standing horses. Methods: Ex vivo study and case series. Methods: One cadaver head, records of 10 normal horses and 14 horses treated with TGPC. Methods: Relevant anatomical landmarks were determined through dissection of one cadaveric specimen and 10 normal radiographic studies. Records of horses diagnosed with empyema or mycosis and treated with standing TGPC were reviewed for complications that occurred during or after the operation. Results: Ex vivo and radiological studies identifie...
Four-step tenoscopic technique to resect a torn proximal manica flexoria while sparing the mesotendons of the deep digital flexor tendon in 30 horses.
Veterinary surgery : VS    November 14, 2025   Volume 55, Issue 2 416-428 doi: 10.1111/vsu.70057
Racine J, Ungermann A, Blatter M, von Plato G, Rijkenhuizen ABM.To describe a modified two-portal tenoscopic technique for proximal manica flexoria (MF) resection designed to preserve the mesotendons (MTs) of the deep digital flexor tendon (DDFT). Methods: Prospective clinical study. Methods: Client-owned horses (n = 30). Methods: MF resection was performed in four steps: (1) Transection of the lateral attachment of the MF to the superficial digital flexor tendon (SDFT), staying abaxial to the lateral MT; (2) transection of the medial attachment of the MF to the SDFT between the flexor tendons from distal to proximal until reaching the level of the med...
Reconstruction of an orbital fracture in a mare using a 3D-printed patient-specific implant.
Veterinary surgery : VS    October 30, 2025   doi: 10.1111/vsu.70050
Gernhardt J, Böttcher P, Eule JC, Mählmann K, Müller E, Lischer CJ.To describe surgical repair of an orbital wall fracture communicating with the caudal maxillary sinus using a three dimensional (3D)-printed, patient-specific implant (PSI). Methods: Case report. Methods: A 25-year-old Haflinger mare (370 kg). Methods: The mare presented with severe chemosis and emphysema of the left upper and lower eyelid of 2-weeks duration due to a fracture of the ventral floor and inner wall of the left orbit that communicated with the caudal maxillary sinus. Computed tomographic (CT) data were used to design a PSI replicating the inner surface of the unfractured orbit. ...
Policresulen is effective for the topical treatment of vaginal varices in a pregnant mare: Case report.
Journal of equine veterinary science    October 30, 2025   Volume 155 105711 doi: 10.1016/j.jevs.2025.105711
Miguel EL, Carneiro MFL, Griffo ALC, Baatsch Nascimento F, Dória RGS, Corrêa RR, Celeghini ECC.Vaginal varicosities in mares are rarely reported, although considered relatively common. Clinical recognition can be challenging, especially during early pregnancy, due to the intermittent nature of the bleeding. This report aims to describe the diagnostic approach, clinical evolution, and treatment of a case of vaginal varicosity in a pregnant mare, emphasizing a practical and minimally invasive method. A 9-year-old Brazilian Sport Horse mare with intermittent vaginal hemorrhage underwent clinical evaluation, showing no abnormalities. Vaginoscopy with a rigid endoscope revealed varicose vein...
Cryptorchidism in Equid: A Retrospective Study on Diagnostic Approach, Anaesthesia Management, Surgical Treatment and Outcomes.
Animals : an open access journal from MDPI    October 9, 2025   Volume 15, Issue 19 2923 doi: 10.3390/ani15192923
Nocera I, Moroni R, Fanelli D, Rota A, Di Franco C, Ungari C, Puccinelli C, Gandini M, Giusto G, Vannozzi I.Over the years, various diagnostic and surgical techniques have been developed to recognise and treat cryptorchidism in equid. This study retrospectively analysed cases of cryptorchidism referred to two centres between 2012 and 2025. Clinical data collected included species, breed, age, gender, location of retained testis, diagnostic approach, anaesthesia plan and surgical treatment, perioperative medical treatment, intra-operative complications and outcomes. A total of 37 clinical cases were included, 1/37 was a donkey and 1/37 was an intersex female. Most of the horses were three years old a...
Modified stapled jejunocecostomy in horses.
Veterinary surgery : VS    October 2, 2025   Volume 55, Issue 2 468-475 doi: 10.1111/vsu.70019
Freeman DE, Smith B, Bauck AG, Denagamage T, Moyer EK, Chanutin S.To develop a modified stapled (MS) jejunocecostomy (JC) in healthy horses. Methods: In vivo experimental study. Methods: Six healthy adult horses underwent ventral midline celiotomy, a jejunal resection, and an MS. Methods: Time to complete anastomosis and anastomotic length at necropsy were recorded. Horses were assessed by physical examination every 6 h for 5 days after surgery, then once daily until euthanasia at 7 days. A group of seven horses that had a stapled side-to-side JC and were euthanized 28 days postoperatively was used as an historical control (SS). Results: All MS horse...
Equine Abdominal Surgery: Predicting and Preventing Postoperative Complications.
The Veterinary clinics of North America. Equine practice    September 24, 2025   Volume 41, Issue 3 495-507 doi: 10.1016/j.cveq.2025.08.003
Mudge M.Morbidity after equine abdominal surgery is common and post-operative complications can be costly to owners. The focus of this article is on intraoperative decision-making and current evidence, including surgical techniques and prognostic information that can prevent and predict complications. Emerging techniques for intra-operative monitoring and intestinal viability assessment, anastomotic techniques, body wall suturing, peritonitis treatment, and pain management are discussed.
Tenoscopically guided proximal digital annular ligament desmotomy for the treatment of proximal digital annular ligament desmitis.
Veterinary surgery : VS    September 16, 2025   Volume 55, Issue 2 383-395 doi: 10.1111/vsu.70021
Wood AD, Parker RA.To describe a tenoscopically guided technique for desmotomy of the proximal digital annular ligament (PDAL). Methods: Ex vivo study and clinical case series. Methods: A total of 10 normal cadaver equine hindlimbs and five clinical cases of PDAL desmitis. Methods: The digital flexor tendon sheath (DFTS) was approached via a lateral basisesamoid portal and a palmar/plantar annular ligament (PAL) desmotomy was performed to improve maneuverability in the DFTS. Additional proximolateral and distal midline instrument portals were created to facilitate transection of the proximolateral attachment, th...
Ultrasound-guided, minimally invasive, biceps brachii tenotomy in a standing horse.
Veterinary surgery : VS    September 11, 2025   Volume 55, Issue 2 491-497 doi: 10.1111/vsu.70017
Marques GF, Moorman VJ, Ellis KL, Perlini M, Edwards VL.To describe the long-term outcome of a horse that underwent a standing, ultrasound-guided, minimally invasive, biceps brachii tenotomy. Methods: Case report. Methods: A 17-year-old Tennessee Walking Horse gelding. Methods: The horse had a chronic, severe, lameness localized to the left shoulder region. Diagnostic imaging revealed fractures of the intermediate and lesser tubercles of the left humerus, biceps brachii (BB) tendinopathy, and bicipital bursitis. Conservative management was attempted, but lack of improvement prompted surgical intervention. An ultrasound-guided, minimally invasive, B...
Laparoscopic cryptorchidectomy in 10 equids using a single incision laparoscopic surgery (SILS) port device.
The Canadian veterinary journal = La revue veterinaire canadienne    September 1, 2025   Volume 66, Issue 9 966-973 
Muñoz AM, Cribb N.Minimally invasive laparoscopic surgical techniques are desirable in horses and other equids. A new approach called "modified single incision laparoscopic surgery (SILS) for equine cryptorchidectomy" is described, along with the postoperative outcomes of 10 equids. A SILS Port device (Covidien) was placed a 30- to 40-millimeter incision in combination with 1 or 2 15-millimeter para-inguinal incisions to exteriorize the intra-abdominal testicles. Ten animals, 2 bilateral abdominal cryptorchid horses and 8 unilateral abdominal cryptorchid equids, underwent cryptorchidectomy using the SILS tech...
Ultrasound-Guided Radiofrequency Ablation and Pulsed Radiofrequency Treatment for Chronic Lameness Due to Distal Forelimb Disease in Horses: A Pilot Study.
Animals : an open access journal from MDPI    August 10, 2025   Volume 15, Issue 16 2341 doi: 10.3390/ani15162341
Amari M, Brioschi FA, Auletta L, Ravasio G.Radiofrequency ablation (RFA) and pulsed radiofrequency (PRF) are non-pharmacological techniques employed in humans for chronic pain, but their veterinary application is unexplored. This pilot study evaluated clinical effects of RFA and PRF in twenty-four horses with chronic distal forelimb lameness. Ultrasound-guided RFA (N = 8; 60-90 °C, 2-8 min) or PRF (N = 16; 42 °C; 12 min) was applied to palmar digital nerves. Lameness was scored (American Association of Equine Practitioners scale) at baseline and monthly for six months (T1-T6). At T2, partial- and non-responders in both groups receive...
Surgical Assessment and Post-Operative Complications Following Video-Assisted Thoracoscopic Surgery (VATS) of Horses with Severe Equine Pasture Asthma During Asthma Exacerbation and Remission.
Animals : an open access journal from MDPI    August 4, 2025   Volume 15, Issue 15 2276 doi: 10.3390/ani15152276
Wenzel CJ, Mochal-King CA, Eddy AL, Bowser JE, Wills RW, Jumper WI, Claude A, Swiderski CE.The aim of this retrospective clinical study was to assess surgical duration and surgical and post-operative complications associated with Video-Assisted Thoracoscopic Surgery (VATS) and lung biopsy in horses with severe Equine Pasture Asthma (EPA) and paired control horses. Twelve horses (6 EPA-affected, 6 control) were sex, age and breed matched. Twenty-four thoracic surgeries were performed. Surgery of each matched pair (EPA-affected and healthy) was performed during asthma exacerbation (summer) and remission (winter). Surgical times were shorter with uncomplicated thoracoscopy (85 min) and...
An Ultrasound-Guided Thoracolumbar Erector Spinae Plane Block: An Experimental Preliminary Study in Horses.
Animals : an open access journal from MDPI    August 1, 2025   Volume 15, Issue 15 2264 doi: 10.3390/ani15152264
Medina-Bautista F, Nocera I, Sánchez de Medina A, Di Franco C, Briganti A, Morgaz J, Granados MDM.The objective of this study was to evaluate the feasibility and efficacy of the ultrasound-guided thoracolumbar erector spinae plane (TL-ESP) block in standing horses. A total of 24 injections ( = 12) were performed at the L1 level using either 0.1 mL/kg of saline solution (SS group) or 2% lidocaine (LID group). The block feasibility was assessed based on needle visualization and injection time, while efficacy was evaluated through craniocaudal and dorsoventral (DV) spread using the pinprick technique over 270 min. Desensitization was observed at least once in 100% of horses in the LID group a...
Advanced equine duodenoscopy technique.
Journal of equine veterinary science    July 30, 2025   Volume 152 105659 doi: 10.1016/j.jevs.2025.105659
Agrícola R, Ribeiro G, Borges J, Carvalho L, Roquet I, Carvalho LM, Prazeres J.Duodenal pathologies are underreported in equine medicine, probably not due to little occurrence, but due to the limitations of current diagnostic techniques. The aim of this report is to describe a novel duodenoscopic approach, that allows a complete visualization of a region inaccessible via standard techniques. Gastroduodenoscopy was performed in a clinical setting in 60 adult horses referred to us due to complaints suspected to be related to gastroduodenal diseases. The initial steps of the procedure were performed using previously published techniques. Once the video-endoscope reached the...
Outcomes of diode laser-facilitated ankylosis of the distal tarsal joints in horses: A retrospective study of 64 cases.
Veterinary surgery : VS    July 28, 2025   doi: 10.1111/vsu.14312
Sanchez-Arjona R, Lopez Cruz C, Hague BA, Jayawickrama J, Kamm JL.To evaluate the outcomes of diode laser-facilitated (DLF) ankylosis using different surgical techniques to treat distal tarsal osteoarthritis (OA) in horses. Methods: Retrospective cohort study. Methods: A total of 64 client-owned horses with distal tarsal OA treated with DLF ankylosis between 2011 and 2021 in a referral hospital were included. Methods: DLF ankylosis techniques included: intra-articular diode laser (L), diode laser with periarticular drilling (L + D) and diode laser with cuboidal bone fenestration (L + F). Horses requiring a second surgery formed a fourth group (T). Ou...
Outcome of arthroscopic debridement for the treatment of incomplete third carpal bone slab fractures in racehorses.
Veterinary surgery : VS    July 9, 2025   doi: 10.1111/vsu.14313
Garcia-Collao MR, Curtiss AL, Hogan PM.To describe the outcomes of arthroscopic debridement of third carpal bone (C3) incomplete slab fractures (ISF) in racehorses. Methods: Retrospective case study. Methods: Horses undergoing arthroscopic debridement of ISF of C3. Methods: The medical records of horses surgically treated for ISF of C3 were reviewed. Age, sex, breed, limb, fracture configuration, preoperative radiographs, arthroscopic findings, postoperative intraarticular therapies, and exercise recommendations were recorded. Racing performance was obtained from online databases. Univariable analyses were used to determine associa...
Efficacy of needle and endoscopic lavage on the recuperation of microspheres from the adult equine metacarpo-/metatarsophalangeal joint and digital flexor tendon sheath.
Veterinary surgery : VS    June 25, 2025   Volume 54, Issue 6 1157-1166 doi: 10.1111/vsu.14298
Beggan CP, Panizzi L, Oliver LJ.To measure microsphere recovery following needle-through-and-through lavage (NTAT) of the metacarpo-/metatarsophalangeal joint (fetlock) and digital flexor tendon sheath (DFTS) compared to endoscopic lavage (EL). Methods: Ex vivo experimental study. Methods: Adult equine cadavers immediately following euthanasia (n = 10). Methods: Colored 15 μm microspheres (2 million) were injected into fetlock joints and DFTS. Synovial structures were assigned to NTAT or EL groups. Each lavage was performed using 5 L of 0.9% NaCl, sequentially collecting egress fluid for microsphere quantification. Re...
Diagnosis and Minimally Invasive Surgical Treatment for Enhancing Intrathecal/Intrasynovial Tendon Injuries.
The Veterinary clinics of North America. Equine practice    June 14, 2025   Volume 41, Issue 2 299-318 doi: 10.1016/j.cveq.2025.04.004
García-López JM.Intrathecal and intrasynovial tendon and ligament injuries can result in extrusion of tendon/ligament fibers, granuloma, and adhesion formation that not only impairs healing of the original injury but can create new injuries that negatively affect adequate healing and return to athletic work. In these cases, endoscopic evaluation and debridement, not only of the lesion, but also any other secondary injury present, can enhance the healing of the tendon or ligament and improve the athletic prognosis. Careful planning of the approach, positioning, instrumentation, and thorough knowledge of the an...
Navigated minimally invasive puncture of the trigeminal cistern in horses-a cadaveric study in preparation for a controlled rhizotomy.
Frontiers in veterinary science    June 13, 2025   Volume 12 1562404 doi: 10.3389/fvets.2025.1562404
de Preux M, Precht C, Becker R, Stieglitz L, Easley J, Koch C.Trigeminal-mediated headshaking is a neuropathic disorder in horses, characterized by signs of regional pain similar to trigeminal neuralgia in humans. The injection of glycerol into the trigeminal cistern to ablate pain-conducting nerve fibers within the trigeminal ganglion -known as glycerol rhizotomy- is a well-established treatment in human medicine. This study compares two approaches to the equine trigeminal cistern using a navigation system for guiding needle placement, a previously described ventral and a newly developed transmandibular lateral approach. The surgical accuracy and risk o...
Direct arthroscopic approach to the distal pouch of the palmar/plantar recess of the metacarpophalangeal/metatarsophalangeal joint in horses.
Veterinary surgery : VS    June 12, 2025   doi: 10.1111/vsu.14290
Foucaud M, Haegeman L, Kadic D, Vinardell T, Mariën T, Declercq J.To describe a direct arthroscopic approach of the distal pouch of the palmar/plantar recess of the fetlock to facilitate fragment removal, highlighting its advantages over previously described arthroscopic methods for the fetlock. Additionally, to evaluate and present a retrospective case series. Methods: Ex vivo and retrospective clinical study. Methods: A total of 25 fetlocks in 23 horses. Methods: A direct approach to the distal pouch of the palmar/plantar recess of the fetlock was developed on five cadaveric limbs. Arthroscopic anatomy and landmarks were examined. The approach was clinical...
Internal fixation of a fractured cranial articular process of the sixth cervical vertebra by means of computer-assisted surgery in a Warmblood gelding.
Veterinary surgery : VS    May 23, 2025   doi: 10.1111/vsu.14273
Käfer-Karrer MJ, de Preux M, Van der Vekens E, Mattei LI, Kuhlmann J, Klopfenstein Bregger MD, Easley JT, Koch C.To describe the repair of a fractured cranial articular process (AP) of the sixth cervical vertebra (C6) with cortex screws placed in lag fashion using computer-assisted surgery. Methods: A 12-year-old Swiss Warmblood gelding. Methods: Case report. Methods: The gelding was presented with neck pain and ataxia after a fall. A fracture of the right cranial AP of C6 was identified on radiographs. The fracture was repaired by internal fixation with two 4.5 mm cortex screws of 58 and 48 mm length placed in lag fashion using computer-assisted surgery. Results: During general anesthesia, it was su...
The Suitability of Dried Blood Spot Sampling for Pharmacokinetic Studies in Veterinary Medicine.
Veterinary sciences    May 18, 2025   Volume 12, Issue 5 488 doi: 10.3390/vetsci12050488
Bardhi A, Barbarossa A, Joubert A, Gehring R, Lambertini C, Romagnoli N.Dried blood spot (DBS) sampling has emerged as a promising microsampling technique in biomedical and clinical research, offering advantages such as reduced invasiveness, minimal blood volume requirements, and enhanced analyte stability. Although well established in human medicine for neonatal screening and diagnostic applications, its potential in veterinary pharmacology remains underexplored. This study investigated the feasibility of using DBS samples to quantify anesthetic agents-ketamine and medetomidine in cats and lidocaine in horses-during routine surgical procedures at a veterinary tea...
Racing and sales performance in Thoroughbred yearlings after carpal osteochondral fragment removal.
Equine veterinary journal    May 15, 2025   doi: 10.1111/evj.14532
Debald DC, Stanton VL, Sandow CB, Rodgerson DH, Spirito MA, Hunt RJ, Menarim BC.While radiographically evident carpal osteochondral fragments (COF) in Thoroughbred yearlings impair sales, their impact on future racing performance has been minimally investigated. Objective: To assess the impact of COF on Thoroughbred yearling sales and racing performance, and whether these are improved by arthroscopic removal. We hypothesised that surgical removal of COF improves Thoroughbred yearling sales and racing performance. Methods: Retrospective observational. Methods: Using clinical records from years 2015-2018, 46 Thoroughbred yearlings with COF were identified and allocated to a...
Accuracy of computer-assisted drilling of equine cervical vertebral bodies using a purpose-built cervical frame-An experimental cadaveric study.
Veterinary surgery : VS    May 15, 2025   Volume 54, Issue 5 898-908 doi: 10.1111/vsu.14271
Maurer T, de Preux M, Precht C, Vidondo B, Koch C.To assess the accuracy of computer-assisted surgery (CAS) of equine cervical vertebrae using a purpose-built cervical frame (CF) for neck stabilization. Methods: Experimental cadaveric study. Methods: Six whole fresh equine cadavers. Methods: Cadavers were positioned in dorsal recumbency with the neck extended within the CF. A cone-beam computed tomography (CBCT)-based surgical navigation system with optical tracking was used. A ventral approach exposed cervical vertebrae C3-C5. In each cadaver, 12 drill corridors were prepared with the patient tracker on the CF (position CF), followed by 12 c...
INJECTION OF THE INSERTION OF THE COLLARAL LIGAMENT OF THE DISTAL INTERPHALANGEAL JOINT IN STANDING HORSES USING THE PALMAR RADIOGRAPHIC-GUIDED APPROACH.
Journal of equine veterinary science    May 7, 2025   105600 doi: 10.1016/j.jevs.2025.105600
Kirkpatrick CJ, Ernst NS, Trumble TN.Injury to the collateral ligament (CL) of the distal interphalangeal joint (DIPJ) is recognized as a source of lameness in horses. Intralesional injection has been advocated to increase return to performance. This study was a proof-of-concept study in standing horses to evaluate success of a palmar radiographic-guided approach for injecting insertions of the DIPJ CLs previously described in cadaver limbs. Horses were sedated, nerve blocked, and placed on wooden blocks with the limb to be injected staggered approximately 20cm cranially to the other limb. The DIPJ CL insertion was injected, usin...
Oral Extraction and Nasal Retrieval of a Fragmented Maxillary Fourth Premolar Tooth in a Horse Using Endoscopic Guidance: A Case Report.
Journal of veterinary dentistry    April 29, 2025   Volume 42, Issue 5 397-406 doi: 10.1177/08987564251334882
Clarysse M, Korsos S, Vlaminck L.This case report presents the removal of the left maxillary fourth premolar tooth (208) which had a chronic complicated crown root fracture in a 9-year-old Warmblood mare. Following a 14-month history of malodorous nasal discharge, clinical and radiographic examination allowed the diagnosis of a comminuted crown root fracture of 208 and oronasal fistula. Some root fragments inaccessible for oral extraction were subsequently removed using a transnasal approach through the existing oronasal fistulous tract using bronchoesophageal forceps under endoscopic guidance. The oronasal fistula was surgic...