Fenestration of the maxillary septal bulla using different surgical approaches and endoscopy systems in horses: An ex vivo study.

This research evaluates different surgical techniques for inspecting sinus cavities and performing fenestration of the maxillary septal bulla in horses. The tested methods included using different types of endoscope systems and approaches for the procedure. The findings indicate that when using a frontal portal as a viewing portal and a caudal maxillary portal as an instrument portal, both inspection and fenestration procedures were successfully executed.

Methodology

• The study was conducted with six chemically preserved horse heads as the subject for the experiment.
• Both frontal and caudal maxillary portals were tested for the procedure. These portals were created in the right and left antimeres of each specimen, over the frontal and the caudal maxillary sinus.
• Two types of rigid 4 mm endoscopes with lens angles of 0º and 30º were utilized for the procedure.

Evaluation

• The primary points of inspection were the comprehensiveness of sinus examination and the applicability of portals for fenestration of the maxillary septal bulla.
• To evaluate the success of the procedure, the researchers inspected whether satisfactory exploration of sinus cavities and structures of interest was achieved, and whether the fenestration operation was successfully executed.

Findings

• The written report suggests that satisfactory exploration of sinus cavities and structures was achieved in all applied cases.
• The fenestration procedure was successfully conducted when using the frontal portals as viewing portals and the caudal maxillary portals as instrument portals.
• However, when using the caudal maxillary portals as viewing portals, the maneuverability of the endoscope was limited due to the presence of the infraorbital canal in 50% of the cases.
• Similarly, using the frontal portals as instrument portals had complications with the frontomaxillary opening interfering with or even preventing appropriate fenestration in a majority of cases.
• In terms of best practice, the study concludes that for effective fenestration of the maxillary septal bulla, frontal portals should be used as viewing portals and caudal maxillary portals as instrument portals.