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Home / Equine Research Bank / Vet Surg / Comparison of equine paranasal sinus trephination complicati...
Veterinary surgery : VS2023; doi: 10.1111/vsu.14013

Comparison of equine paranasal sinus trephination complications and outcome following standing computed tomography, radiography and sinoscopy guided approaches for the treatment of sinusitis.

Abstract: The recent availability of standing computed tomography (CT) for equine paranasal sinus disease has enhanced diagnosis and enabled more targeted surgery compared to radiography and sinoscopy. To date, there have been no studies which have critically evaluated the benefit of preoperative CT versus radiography and sinoscopy on complications and outcome in horses undergoing sinus trephination. Methods: Retrospective study. Methods: A total of 229 equids. Methods: The medical records of equids (229) presented for sinusitis treated via trephination that had CT, radiography and/or sinoscopy at time of surgery between 2009 and 2022 were reviewed. Outcome and complications were evaluated for six different pre- and intraoperative imaging modalities. Results: The six groups did not differ in demographics or disease category, though equids with less weight (p = .0179) and shorter disease duration (p = .0075) were more likely to have radiography and sinoscopy based surgical planning. Short-term postoperative complications occurred in 30.1% and were higher in groups using preoperative CT imaging (p = .01), with hemorrhage being the most common surgical complication. Following initial trephination surgery, 57.0% (127/223) of cases resolved and there was no difference between the imaging groups. Final resolution after follow-up medical or surgical treatment increased to 94.6% (211/223) and was not different between the imaging groups or between primary or secondary sinusitis. Additional nasal fenestrations to improve sinonasal drainage, maxillary septal bulla fenestrations and trephinations to treat nasal conchal bullae were made in the CT groups. Conclusions: CT provided additional diagnostic information and enabled different surgical approaches but did not improve resolution in this study population.
© 2023 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
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Publication Date: 2023-08-21 PubMed ID: 37602997DOI: 10.1111/vsu.14013Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This study reviews the outcomes in horses with sinusitis that were treated using different imaging techniques – computed tomography (CT), radiography, or sinoscopy – before sinus surgery. The researchers found that while CT provided more diagnostic details and different surgical approaches, it did not improve the final outcome even though short-term postoperative complications were higher in this group.

Research Methodology

  • The research is a retrospective study, examining pre-existing data rather than performing a new, controlled experiment.
  • Medical records of 229 horses suffering from sinusitis that underwent trephination (drilling of holes for surgical access) between 2009 and 2022 were reviewed.
  • The records studied were for treatments that used one of three imaging techniques before surgery – CT, radiography, and sinoscopy.
  • The impact on outcomes and complications were studied for six different combinations of pre- and intraoperative imaging techniques.

Key Findings

  • There were no significant differences in the demographics of the six groups or the categories of the disease they suffered from.
  • However, horses with a lower body weight and a shorter duration of disease were more likely to be treated with planning based on radiography and sinoscopy.
  • 30.1% cases experienced short-term post-operative complications, which were more common in groups that used CT imaging before surgery, with hemorrhage being the most common surgical complication.
  • More than half (57%) of the cases resolved after initial trephination surgery, and there was no observable difference in outcomes between the groups using different imaging techniques.
  • The final resolution rate, including cases needing follow-up treatment, was almost 95%, without any significant variations between the groups using different imaging techniques, or between cases of primary or secondary sinusitis.

Conclusions and Implications

  • The research finds that while CT allows for more comprehensive diagnostic detail, leading to different surgical approaches, it doesn’t necessarily lead to improved outcomes in the treatment of equine sinusitis.
  • Additionally, the short-term postoperative complication rate was higher in cases that used preoperative CT imaging, a significant consideration for veterinary professionals planning treatment pathways.
  • The conclusion suggests that while CT can offer additional information and enables alternative surgical approaches, it hasn’t shown a significant difference in improving resolution of sinusitis in this study’s population.

Cite This Article

APA
Hopfgartner T, Brown JA, Adams MN, Werre SR. (2023). Comparison of equine paranasal sinus trephination complications and outcome following standing computed tomography, radiography and sinoscopy guided approaches for the treatment of sinusitis. Vet Surg. https://doi.org/10.1111/vsu.14013

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English

Researcher Affiliations

Hopfgartner, Teresa
  • Department of Large Animal Clinical Sciences, Marion duPont Scott Equine Medical Center, Virginia - Maryland Regional College of Veterinary Medicine, Leesburg, Virginia, USA.
Brown, James A
  • Department of Large Animal Clinical Sciences, Marion duPont Scott Equine Medical Center, Virginia - Maryland Regional College of Veterinary Medicine, Leesburg, Virginia, USA.
  • School of Veterinary Medicine, Texas Tech University, Amarillo, Texas, USA.
Adams, M Norris
  • Department of Large Animal Clinical Sciences, Marion duPont Scott Equine Medical Center, Virginia - Maryland Regional College of Veterinary Medicine, Leesburg, Virginia, USA.
Werre, Stephen R
  • Population Health Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia, USA.

References

This article includes 38 references
  1. Freeman DE. Sinus disease.. Vet Clin North Am Equine Pract 2003;19:209-243. viii.
  2. Beste KJ, Lawhon SD, Chamoun-Emanuelli AM. Culture-independent and dependent evaluation of the equine paranasal sinus microbiota in health and disease.. Equine Vet J 2020;52:455-463.
  3. Lowman ME, Tipton CD, Labordere AL. Equine sinusitis aetiology is linked to sinus microbiome by amplicon sequencing.. Equine Vet J 2022;55:798-807.
  4. van der Velden MA, Verzijlenberg F. De chronische purulente sinusitis maxillaris bij het paard [chronic purulent maxillary sinusitis in horses].. Tijdschr Diergeneeskd 1984;109:793-799.
  5. O'Leary JM, Dixon PM. A review of equine paranasal sinusitis. Aetiopathogenesis, clinical signs and ancillary diagnostic techniques.. Equine Vet Educ 2011;23:148-159.
  6. Tremaine WH, Dixon PM. A long-term study of 277 cases of equine sinonasal disease. Part 2: treatments and results of treatments.. Equine Vet J 2001;33:283-289.
  7. Gibbs C, Lane JG. Radiographic examination of the facial, nasal and paranasal sinus regions of the horse. II. Radiological findings.. Equine Vet J 1987;19:474-482.
  8. Tremaine WH, Dixon PM. A long-term study of 277 cases of equine sinonasal disease. Part 1: details of horses, historical, clinical and ancillary diagnostic findings.. Equine Vet J 2001;33:274-282.
  9. Rowley KJ, Fiske-Jackson AR, Williams JM, Jones AL, Townsend NB. Surgical management of a sinonasal angiomatous polyp and associated cyst involving the paranasal sinuses and nasal cavity via standing axial rhinotomy.. Equine Vet Educ 2021;33:e120-e125.
  10. Hart SK, Sullins KE. Evaluation of a novel post operative treatment for sinonasal disease in the horse (1996-2007).. Equine Vet J 2011;43:24-29.
  11. Dixon PM, Parkin TD, Collins N. Equine paranasal sinus disease: a long-term study of 200 cases (1997-2009): treatments and long-term results of treatments.. Equine Vet J 2012;44:272-276.
  12. Dixon PM, Kennedy R, Poll K, Barakzai S, Reardon RJM. A long-term study of sinoscopic treatment of equine paranasal sinus disease: 155 cases (2012-2019).. Equine Vet J 2021;53:979-989.
  13. Dixon PM, Barnett TP, Morgan RE, Reardon RJM. Computed tomographic assessment of individual paranasal sinus compartment and nasal Conchal bulla involvement in 300 cases of equine Sinonasal disease.. Front Vet Sci 2020;7:580356.
  14. Manso-Díaz G, García-López JM, Maranda L, Taeymans O. The role of head computed tomography in equine practice.. Equine Vet Educ 2015;27:136-145.
  15. Han JK, Hwang PH. Image-guided trephination of the frontal sinus: an adjunct to endoscopic technique.. Oper Tech Otolaryngol Head Neck Surg 2004;15:57-60.
  16. Ruggles AJ, Ross MW, Freeman DE. Endoscopic examination and treatment of paranasal sinus disease in 16 horses.. Vet Surg 1993;22:508-514.
  17. Dixon PM, Froydenlund T, Luiti T. Empyema of the nasal Conchal bulla as a cause of chronic unilateral nasal discharge in the horse: 10 cases (2013-2014).. Equine Vet J 2015;47:445-449.
  18. Dixon PM, Dacre I, Dacre K, Tremaine WH, McCann J, Barakzai S. Standing oral extraction of cheek teeth in 100 horses (1998-2003).. Equine Vet J 2005;37:105-112.
  19. Mueller SA, Caversaccio M. Outcome of computer-assisted surgery in patients with chronic rhinosinusitis.. J Laryngol Otol 2010;124:500-504.
  20. Casiano RR, Numa WA Jr. Efficacy of computed tomographic image-guided endoscopic sinus surgery in residency training programs.. Laryngoscope 2000;110:1277-1282.
  21. Burke TF, Guertler AT, Timmons JH. Comparison of sinus x-rays with computed tomography scans in acute sinusitis.. Acad Emerg Med 1994;1:235-239.
  22. Henninger W, Frame EM, Willmann M. CT features of alveolitis and sinusitis in horses.. Vet Radiol Ultrasound 2003;44:269-276.
  23. Barker WHJ, Perkins JD, Witte TH. Three horses with bilateral sinonasal progressive haematomas not associated with the ethmoidal labyrinth.. Equine Vet Educ 2013;25:503-507.
  24. Dixon PM, Parkin TD, Collins N. Equine paranasal sinus disease: a long-term study of 200 cases (1997-2009): ancillary diagnostic findings and involvement of the various sinus compartments.. Equine Vet J 2012;44:267-271.
  25. van Zadelhoff C, Liuti T, Dixon PM. Multidetector CT and cone-beam CT have substantial agreement in detecting dental and sinus abnormalities in equine cadaver heads.. Vet Radiol Ultrasound 2021;62:413-420.
  26. Freeman DE, Orsini PG, Ross MW. A large frontonasal bone flap for sinus surgery in the horse.. Vet Surg 1990;19:122-130.
  27. Greet TR. Outcome of treatment in 23 horses with progressive ethmoidal haematoma.. Equine Vet J 1992;24:468-471.
  28. Quinn GC, Kidd JA, Lane JG. Modified frontonasal sinus flap surgery in standing horses: surgical findings and outcomes of 60 cases.. Equine Vet J 2010;37:138-142.
  29. Schumacher J, Acvs D, Dutton DM. Paranasal sinus surgery through a frontonasal flap in sedated, standing horses.. Vet Surg 2000;29:173-177.
  30. Barakzai SZ, Dixon PM. Standing Equine Sinus Surgery.. W.B. Saunders; 2014:45-62.
  31. Woodford NS, Lane JG. Long-term retrospective study of 52 horses with sinunasal cysts.. Equine Vet J 2010;38:198-202.
  32. Divers TJ, Radcliffe RM, Cook VL, Bookbinder LC, Hurcombe SDA. Calculating and selecting fluid therapy and blood product replacements for horses with acute hemorrhage.. J Vet Emerg Crit Care (San Antonio) 2022;32:97-107.
  33. Bach FS, Bohler A, Schieder K. Surgical enlargement of the nasomaxillary aperture and transnasal conchotomy of the ventral Conchal sinus: two surgical techniques to improve sinus drainage in horses.. Vet Surg 2019;48:1019-1031.
  34. Carmalt JL. Intraoperative depression of the bulla of the maxillary septum as a method of improving sinus drainage without epistaxis in horses.. Equine Vet Educ 2020;33:489-493.
  35. Dixon PM, O'Leary JM. A review of equine paranasal sinusitis: Medical and surgical treatments.. Equine Vet Educ 2012;24(3):143-158.
  36. Soma LR, Robinson MA, You Y, Boston RC, Rudy J. Pharmacokinetics, disposition, and plasma concentrations of dimethyl sulfoxide (DMSO) in the horse following topical, oral, and intravenous administration.. J Vet Pharmacol Ther 2018;41:384-392.
  37. Ball MA, Rebhun WC, Trepanier L, Gaarder J, Schwark WS. Corneal concentrations and preliminary toxicological evaluation of an itraconazole/dimethyl sulphoxide ophthalmic ointment.. J Vet Pharmacol Ther 1997;20:100-104.
  38. Yahya M, Alias Z, Karsani SA. Antibiofilm activity and mode of action of DMSO alone and its combination with afatinib against gram-negative pathogens.. Folia Microbiol (Praha) 2018;63:23-30.

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