Intrasinus bolstering of traumatic maxillary sinus fractures by using Foley catheter balloons in two foals.
Abstract: To describe the repair of unstable facial fractures by using Foley catheter balloons as intrasinus bolsters. Methods: Case report ANIMALS: Two weanling foals with unilateral fractures of the sinus and orbit secondary to kick injuries. Preoperative imaging that included positive contrast dacrocystorhinography and computed tomography confirmed severe comminution of facial fractures and nasolacrimal duct disruption in both foals. Methods: Small bone fragments were surgically removed, and large fragments were retained even when denuded of periosteum. Repair procedures included nasolacrimal canaliculosinusotomy and suturing fracture fragments together with polydioxanone sutures. After fixation, the fracture fragments could be depressed into the sinus with manual pressure, so two intrasinus Foley catheters were placed to bolster the sinus wall, with the tubing exiting through a frontal sinus trephine. The skin was completely closed over the fractures. Catheters and nasolacrimal stenting were maintained in place during fracture healing. Results: One foal prematurely dislodged catheters and nasolacrimal stent 11 days after fixation. The catheters and stenting were removed as planned 4 weeks after surgery in the second foal. Wound, fracture healing, and overall cosmesis was good in both foals, and epiphora resolved. Surgical site infection, sinusitis, and sequestration did not occur. Both foals became high-level performance horses with acceptable cosmetic outcome and good bilateral nasal airflow. Conclusions: Foley catheter balloons supported sinus fracture repair and maintained stability of the surgical reconstruction during convalescence. Conclusions: Suture repair of comminuted sinus fractures can be supported by using Foley catheters, which are readily available.
© 2020 The American College of Veterinary Surgeons.
Publication Date: 2020-04-29 PubMed ID: 32347989DOI: 10.1111/vsu.13433Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Case Reports
- Journal Article
- Anatomy
- Bones
- Case Reports
- Clinical Findings
- Clinical Pathology
- Clinical Study
- Clinical Symptoms
- Computed Tomography
- Diagnosis
- Diagnostic Imaging
- Disease Diagnosis
- Disease Treatment
- Equine Diseases
- Equine Health
- Foals
- Fractures
- Horses
- Imaging Techniques
- In Vivo
- Infection
- Injury
- Post-Operative Period
- Radiology
- Surgery
- Trauma
- Veterinary Care
- Veterinary Medicine
- Veterinary Practice
- Veterinary Procedure
- Veterinary Research
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.
The research investigates a novel method of repairing severe facial fractures in two foals using Foley catheter balloons as intrasinus supports. The study noted successful outcomes, with both foals recovering without significant complications and maintaining good nasal airflow.
Reflection on the Purpose and Methodology of the Research
- This research was conducted to address the treatment of serious facial fractures in young horses (or foals) which resulted from kick injuries.
- The paper provides a case report (based on two foals) that explores the use of a Foley catheter balloon as a bolster for intrasinal support.
- The fractures in the foals were diagnosed using preoperative imaging techniques which include contrast dacrocystorhinography and computed tomography.
- Using surgical procedures, smaller bone fragments were removed while larger fragments, even those without periosteum, were retained.
- The fractures were then repaired using nasolacrimal canaliculostomy (a surgical procedure) and stitching the fragmented pieces using polydioxanone sutures.
- After surgical fixation, the fracture fragments could be depressed into the sinus under gentle manual pressure. This was followed by placing two Foley catheter intrasinus to provide increased support for the sinus wall.
- The catheters and nasolacrimal stenting were maintained during the healing process, and complete closure of skin was done over these fractures.
Results
- The first foal unintentionally dislodged the catheters and nasolacrimal stent 11 days after fixation, while in the second foal, the catheters and stenting were removed intentionally 4 weeks after the operation.
- Both foals showed good wound and fracture healing along with an improvement in their overall appearance. Notably, no occurrences of infection, sinusitis, or sequestration happened.
- Positive outcomes were observed in both foals as they grew to become high-performance horses, with good bilateral nasal airflow and an acceptable cosmetic outcome.
Conclusions
- The Foley catheter balloons were able to successfully provide support to repair sinus fractures, maintaining stability through convalescence.
- This method demonstrates potential as an easily available resource to bolster suture repair for comminuted sinus fractures in foals.
Cite This Article
APA
Gardner AK, Santschi EM, Mudge MC, Belknap JK, Metzler AG.
(2020).
Intrasinus bolstering of traumatic maxillary sinus fractures by using Foley catheter balloons in two foals.
Vet Surg, 49(6), 1255-1261.
https://doi.org/10.1111/vsu.13433 Publication
Researcher Affiliations
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio.
- Department of Clinical Sciences, Kansas State University, Manhattan, Kansas.
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio.
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio.
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio.
MeSH Terms
- Animals
- Catheterization / veterinary
- Catheters / statistics & numerical data
- Female
- Fracture Healing
- Fractures, Comminuted / surgery
- Fractures, Comminuted / veterinary
- Horses / injuries
- Horses / surgery
- Lacrimal Apparatus Diseases / veterinary
- Maxillary Sinus / injuries
- Maxillary Sinus / surgery
- Nasolacrimal Duct / surgery
- Orbital Fractures / surgery
- Orbital Fractures / veterinary
- Skull Fractures / surgery
- Skull Fractures / veterinary
- Stents / veterinary
- Tomography, X-Ray Computed / veterinary
- Wound Healing
References
This article includes 20 references
- Little C, Hilbert B, McGill C. A retrospective study of head fractures in 21 horses.. Aust Vet J 1985;62(3):89-91.
- Turner AS. Surgical management of depression fractures of the equine skull.. Vet Surg 1979;8(2):29-33.
- Schaaf K, Kannegieter N, Lovell D. Management of equine skull fractures using fixation with polydioxanone sutures.. Aust Vet J 2008;86(12):481-485.
- McMaster M, Caldwell F, Gillen A, Hespel A, Budny P, Abarca E. Reconstruction of a complicated orbital depression fracture with medial wall and globe repositioning in a horse: a collaboration across disciplines and specialties.. Vet Surg 2016;45(4):529-535.
- Dowling B, Dart A, Trope G. Surgical repair of skull fractures in four horses using cuttable bone plates.. Aust Vet J 2001;79(5):324-327.
- Auer JA. Mandible, maxilla and skull.. In: Fackelman GE, Auer JA, Nunamaker DM, eds. AO Principles of Equine Osteosynthesis. Stuttgart, Germany: Thieme; 2000:35-36.
- Schumacher J, Brink P. Treatment of horses for a facial or oral fistula.. Equine Vet Educ 2011;23(5):242-248.
- Kashimura T, Soejima K, Kikuchi Y, Nakazawa H. Stability of orbital floor fracture fixation after endoscope-assisted balloon placement.. J Craniofac Surg 2017;28(7):e669-e672.
- Wilson D, Levine S. Surgical reconstruction of the nasolacrimal system in the horse.. J Equine Vet Sci 1991;11(4):232.
- Brink P, Schumacher J. Canaliculosinostomy as a long-term treatment of seven horses for permanent obstruction of the nasolacrimal duct.. Vet Surg 2016;45(1):110-114.
- Robinson CS, Wylie CE, Compston PC, Payne RJ. Alleviation of epiphora by canaliculosinostomy into the caudal maxillary sinus in the horse.. Vet Surg 2016;45(1):115-120.
- Wilkie D. Ophthalmic procedures and surgery in the standing horse.. Vet Clin North Am Equine Pract 1991;7(3):535-547.
- Caron J, Barber S, Bailey J, Fretz P, Pharr J. Periorbital skull fractures in five horses.. J Am Vet Med Assoc 1986;188(3):280-284.
- Gerding J, Clode A, Gilger B, Montgomery K. Equine orbital fractures: a review of 18 cases (2006-2013).. Vet Ophthalmol 2014;17(Suppl 1):97-106.
- Tietje S, Becker M, Böckenhoff G. Computed tomographic evaluation of head diseases in the horse: 15 cases.. Equine Vet J 1996;28(2):98-105.
- Solano M, Brawer R. CT of the equine head: technical considerations, anatomical guide, and selected diseases.. Clin Tech Equine Pract 2004;3(4):374-388.
- Smallwood J, Wood B, Taylor E, Tate L Jr. Anatomic reference for computed tomography of the head of the foal.. Vet Radiol Ultrasound 2002;43(2):99-117.
- Nykamp S, Scrivani P, Pease A. Computed tomography dacryocystography evaluation of the nasolacrimal apparatus.. Vet Radiol Ultrasound 2004;45(1):23-28.
- Crijns CP, Weller R, Vlaminck L. Comparison between radiography and computed tomography for diagnosis of equine skull fractures.. Equine Vet Educ 2019;31(10):543-550.
- Tremaine W, Dixon P. A long-term study of 277 cases of equine sinonasal disease. Part 2: treatments and results of treatments.. Equine Vet J 2001;33(3):283-289.
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists
