A large frontonasal bone flap for sinus surgery in the horse.

The research article details a surgical technique used on 14 horses for treating diseases of the paranasal sinuses. The study found the procedure to be effective, leading to healed sinuses without recurring issues and horses able to return to their pre-surgery activities.

Objective and Procedure

• The study wanted to test a large frontonasal bone flap surgical procedure as a strategy to treat diseases of the paranasal sinuses in horses.
• The researchers treated 14 horses using this method. They created the flap large enough to open the floor of the frontal sinus and the dorsal and ventral conchae, but without interfering with the nasolacrimal duct.
• Opening these sections allowed the physicians to access the nasal passages, maxillary sinuses, and ventral conchal sinus, making it easier to remove localized and diffuse lesions.

Diseases Treated and Outcomes

• The diseases treated with this new method included ethmoid hematomas, sinus cysts, cryptococcal granuloma, osteoma, hemangiosarcoma, pus in the ventral conchal sinus, and periapical infection of a second molar.
• Unfortunately, four horses had to be euthanized either during or after the surgical procedure. One of these deaths was a result of postsurgical complications such as pleuritis and pneumonia while others were due to their primary health issues.
• Four horses developed skin suture abscesses which were treated successfully.
• However, despite these setbacks, ten horses survived, resumed their previous activities, and their sinus flaps healed without any visible blemishes.

Comparison to Other Techniques

• The researchers found that the frontonasal flap technique provided greater access to all paranasal sinuses in comparison to the methods described previously in literature.
• The major advantage of this method was that it addressed the initial health issues without causing any recurrence, showing a significant improvement over other methods.