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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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  • Journal Article

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.

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Citations

This article has been cited 2 times.
  1. Kelley JL, Rawlinson JE, Bell CM. Equine maxillofacial intraosseous cystic lesions: a retrospective study of 17 cases. Front Vet Sci 2025;12:1644866.
    doi: 10.3389/fvets.2025.1644866pubmed: 41001063google scholar: lookup
  2. Borowska M, Lipowicz P, Daunoravičienė K, Turek B, Jasiński T, Pauk J, Domino M. Three-Dimensional Segmentation of Equine Paranasal Sinuses in Multidetector Computed Tomography Datasets: Preliminary Morphometric Assessment Assisted with Clustering Analysis. Sensors (Basel) 2024 May 30;24(11).
    doi: 10.3390/s24113538pubmed: 38894336google scholar: lookup
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