Analyze Diet
Veterinary medicine and science2021; 7(6); 2209-2218; doi: 10.1002/vms3.607

Outcomes following single, caudally based bilateral versus unilateral frontonasal sinusotomy for treatment of equine paranasal sinus disease.

Abstract: Bilateral sinus disease is relatively uncommon in horses, accounting for 3%-4.5% of horses with sinonasal disease, but may require bilateral paranasal surgery for complete resolution. Complications and recurrence following bilateral sinusotomy have not been reported or compared to those following unilateral procedures. To describe clinical features and outcomes in horses undergoing standing single, caudally based bilateral frontonasal sinusotomy compared to unilateral frontonasal surgery. Records of horses (n = 37) undergoing surgical treatment for sinus disease (five bilateral, 32 unilateral) were retrospectively reviewed (2010-2017) for signalment, presenting complaint, duration of signs preoperatively, diagnostic imaging, treatments administered, duration hospitalization, complications, and owner satisfaction with the procedure. Mann-Whitney testing was used to compare age, duration of hospitalization, and follow-up time in horses undergoing unilateral or bilateral procedures. Fisher's exact testing was used to determine if sex predilection was present for unilateral or bilateral disease. Survival time and time to recurrence were compared by Kaplan-Meier survival curves and log-rank curve comparison testing. Significance was assessed at p < 0.05. Length of signs prior to admission did not differ between horses with unilateral and bilateral disease (p = 0.09), but there was a tendency for horses with bilateral disease to have clinical signs for longer. Age (p = 0.19) and hospitalization duration (p = 0.53) did not differ between horses undergoing unilateral versus bilateral procedures. Recurrence or failure to resolve signs was reported in 11/32 (34%) of unilateral and 0/5 bilateral cases (p = 0.07). The bilateral single, caudally based sinusotomy approach may be considered to effectively treat bilateral paranasal sinus disease without concern for increased risk of life-threatening complications or longer hospitalization duration than would be typical for unilateral sinusotomy procedures.
Publication Date: 2021-08-17 PubMed ID: 34405566PubMed Central: PMC8604118DOI: 10.1002/vms3.607Google 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
  • Research Support
  • N.I.H.
  • Extramural
  • Research Support
  • Non-U.S. Gov't

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 examines the outcomes of two types of surgical treatments for equine paranasal sinus disease, unilateral and bilateral sinusotomy. It concludes that bilateral sinusotomy may be a more effective treatment for bilateral paranasal sinus disease, without leading to increased risks or extended hospital stays.

Clinical Features and Outcomes

  • The researchers describe the clinical features and outcomes of horses who underwent a standing single, caudally based bilateral frontonasal sinusotomy as compared to those who had a unilateral frontonasal surgery.
  • The surgical treatments were administered to a total of 37 horses suffering from sinus disease. Out of these, five underwent bilateral sinusotomy, while 32 had a unilateral procedure.
  • The study retrospectively reviews the records of these horses from 2010 to 2017, including their symptoms, duration of signs preoperatively, diagnostic imaging, treatments received, duration of hospitalization, complications, and owner satisfaction.

Comparative Analysis

  • The researchers used Mann-Whitney testing to compare age, duration of hospital stay, and follow-up time in horses undergoing either unilateral or bilateral procedures.
  • Fisher’s exact test was used to find out if a sex predilection existed for unilateral or bilateral disease.
  • Survival time and time to recurrence were compared using Kaplan-Meier survival curves and log-rank curve comparison testing.

Results

  • The study found no significant difference in the length of signs prior to admission between horses with unilateral and bilateral disease. However, there was a tendency for horses with bilateral disease to show clinical signs for a longer period.
  • There was no significant difference in terms of age and hospitalization duration between horses undergoing unilateral versus bilateral procedures.
  • Recurrence or failure to resolve signs was reported in 34% of unilateral cases and none of the bilateral cases, although the difference was marginally non-significant (p=0.07).
  • Overall, the study suggests that, for treating bilateral paranasal sinus disease, the bilateral single, caudally based sinusotomy method may be a preferred choice, as it didn’t show an increased risk of life-threatening complications or longer hospitalization duration compared to unilateral sinusotomy procedures.

Cite This Article

APA
Pezzanite LM, Hackett ES, McCready E, Easley JT. (2021). Outcomes following single, caudally based bilateral versus unilateral frontonasal sinusotomy for treatment of equine paranasal sinus disease. Vet Med Sci, 7(6), 2209-2218. https://doi.org/10.1002/vms3.607

Publication

ISSN: 2053-1095
NlmUniqueID: 101678837
Country: England
Language: English
Volume: 7
Issue: 6
Pages: 2209-2218

Researcher Affiliations

Pezzanite, Lynn M
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Hackett, Eileen S
  • Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
McCready, Erin
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Easley, Jeremiah T
  • Preclinical Surgical Research Laboratory, Department of Clinical Sciences, Veterinary Teaching Hospital, Translational Medicine Institute, Colorado State University, Fort Collins, Colorado, USA.

MeSH Terms

  • Animals
  • Horse Diseases / diagnosis
  • Horse Diseases / surgery
  • Horses
  • Paranasal Sinus Diseases / surgery
  • Paranasal Sinus Diseases / veterinary
  • Retrospective Studies

Grant Funding

  • TL1 TR002533 / NCATS NIH HHS
  • T32 OD010437 / NIH HHS

Conflict of Interest Statement

The authors declare no conflict of interest.

References

This article includes 32 references
  1. Abrão J, Fernandes CR, White PF, Shimano AC, Okubo R, Lima GB, Bachur JA, Garcia SB. Effect of local anaesthetic infiltration with bupivacaine and ropivacaine on wound healing: a placebo-controlled study.. Int Wound J 2014 Aug;11(4):379-85.
  2. Barakzai S. Standing sinus surgery in the horse: Indications, techniques, and complications. In Practice 30, 252–262.
  3. Barakzai SZ, Dixon PM. Standing equine sinus surgery.. Vet Clin North Am Equine Pract 2014 Apr;30(1):45-62.
    pubmed: 24680206doi: 10.1016/j.cveq.2013.11.004google scholar: lookup
  4. Bardell D, Iff I, Mosing M. A cadaver study comparing two approaches to perform a maxillary nerve block in the horse.. Equine Vet J 2010 Nov;42(8):721-5.
  5. Baxter R, Bramlett K, Onel E, Daniels S. Impact of local administration of liposome bupivacaine for postsurgical analgesia on wound healing: a review of data from ten prospective, controlled clinical studies.. Clin Ther 2013 Mar;35(3):312-320.e5.
  6. Beard WL, Robertson JT, Leeth B. Bilateral congenital cysts in the frontal sinuses of a horse.. J Am Vet Med Assoc 1990 Feb 1;196(3):453-4.
    pubmed: 2298677
  7. Biçer C, Yontar Y, Gökahmetoğlu G, Eskitaşçıoğlu T. Comparison of Effects of Levobupivacaine and Ropivacaine Infiltration on Cutaneous Wound Healing in a Rat Model.. J Invest Surg 2018 Dec;31(6):515-520.
    pubmed: 28925761doi: 10.1080/08941939.2017.1363325google scholar: lookup
  8. Coumbe KM, Jones RD, Kenward JH. Bilateral sinus empyema in a six-year-old mare.. Equine Vet J 1987 Nov;19(6):559-60.
  9. Dixon PM, Parkin TD, Collins N, Hawkes C, Townsend N, Tremaine WH, Fisher G, Ealey R, Barakzai SZ. 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 May;44(3):267-71.
  10. Dixon PM, Parkin TD, Collins N, Hawkes C, Townsend N, Tremaine WH, Fisher G, Ealey R, Barakzai SZ. Equine paranasal sinus disease: a long-term study of 200 cases (1997-2009): treatments and long-term results of treatments.. Equine Vet J 2012 May;44(3):272-6.
  11. Dixon PM, Parkin TD, Collins N, Hawkes C, Townsend NB, Fisher G, Ealey R, Barakzai SZ. Historical and clinical features of 200 cases of equine sinus disease.. Vet Rec 2011 Oct 22;169(17):439.
    pubmed: 21868434doi: 10.1136/vr.d4844google scholar: lookup
  12. Easley JT, Freeman DE. A single caudally based frontonasal bone flap for treatment of bilateral mucocele in the paranasal sinuses of an American miniature horse.. Vet Surg 2013 May;42(4):427-32.
  13. Freeman DE, Orsini PG, Ross MW, Madison JB. A large frontonasal bone flap for sinus surgery in the horse.. Vet Surg 1990 Mar-Apr;19(2):122-30.
  14. Hancı V, Hakimoğlu S, Özaçmak H, Bektaş S, Özaçmak HS, Özdamar SO, Yurtlu S, Turan IÖ. Comparison of the effects of bupivacaine, lidocaine, and tramadol infiltration on wound healing in rats.. Rev Bras Anestesiol 2012 Nov-Dec;62(6):799-810.
    pubmed: 23176988doi: 10.1016/s0034-7094(12)70180-0google scholar: lookup
  15. Head KW, Dixon PM. Equine nasal and paranasal sinus tumours. Part 1: review of the literature and tumour classification.. Vet J 1999 May;157(3):261-78.
    pubmed: 10328838doi: 10.1053/tvjl.1998.0370google scholar: lookup
  16. Kesici S, Kesici U, Ulusoy H, Erturkuner P, Turkmen A, Arda O. [Effects of local anesthetics on wound healing].. Braz J Anesthesiol 2018 Jul-Aug;68(4):375-382.
    pmc: PMC9391713pubmed: 29884529doi: 10.1016/j.bjan.2018.01.016google scholar: lookup
  17. O'Neill HD, Garcia-Pereira FL, Mohankumar PS. Ultrasound-guided injection of the maxillary nerve in the horse.. Equine Vet J 2014 Mar;46(2):180-4.
    pubmed: 23679076doi: 10.1111/evj.12106google scholar: lookup
  18. Ostrowska J, Lindström L, Tóth T, Hansson K, Uhlhorn M, Ley CJ. Computed tomography characteristics of equine paranasal sinus cysts.. Equine Vet J 2020 Jul;52(4):538-546.
    doi: 10.1111/evj.13212pubmed: 31793020google scholar: lookup
  19. Panneerselvam E, Balasubramanian S, Raja V B K, Kannan R, Rajaram K, Rajendra Sharma A. 'Plain lignocaine' vs 'Lignocaine with vasoconstrictor'-Comparative evaluation of pain during administration and post-extraction wound healing by a double blinded randomized controlled clinical trial.. Acta Odontol Scand 2016 Jul;74(5):374-9.
    pubmed: 27180994doi: 10.3109/00016357.2016.1160148google scholar: lookup
  20. Quinn GC, Kidd JA, Lane JG. Modified frontonasal sinus flap surgery in standing horses: surgical findings and outcomes of 60 cases.. Equine Vet J 2005 Mar;37(2):138-42.
    pubmed: 15779626doi: 10.2746/0425164054223750google scholar: lookup
  21. Robert MP, Stemmet GP, Smit Y. A bilateral sinus cyst treated via a bilateral frontonasal bone flap in a standing horse.. J S Afr Vet Assoc 2019 Mar 28;90(0):e1-e6.
    pmc: PMC6556708pubmed: 31038323doi: 10.4102/jsava.v90i0.1729google scholar: lookup
  22. Schumacher J, Dutton DM, Murphy DJ, Hague BA, Taylor TS. Paranasal sinus surgery through a frontonasal flap in sedated, standing horses.. Vet Surg 2000 Mar-Apr;29(2):173-7.
  23. Silva LC, Zoppa AL, Fernandes WR, Baccarin RY, Machado TS. Bilateral sinus cysts in a filly treated by endoscopic sinus surgery.. Can Vet J 2009 Apr;50(4):417-20.
    pmc: PMC2657528pubmed: 19436452
  24. Staszyk C, Bienert A, Bäumer W, Feige K, Gasse H. Simulation of local anaesthetic nerve block of the infraorbital nerve within the pterygopalatine fossa: anatomical landmarks defined by computed tomography.. Res Vet Sci 2008 Dec;85(3):399-406.
    pubmed: 18371997doi: 10.1016/j.rvsc.2008.02.008google scholar: lookup
  25. Stauffer S, Cordner B, Dixon J, Witte T. Maxillary nerve blocks in horses: an experimental comparison of surface landmark and ultrasound-guided techniques.. Vet Anaesth Analg 2017 Jul;44(4):951-958.
    pubmed: 28720393doi: 10.1016/j.vaa.2016.09.005google scholar: lookup
  26. Textor JA, Puchalski SM, Affolter VK, MacDonald MH, Galuppo LD, Wisner ER. Results of computed tomography in horses with ethmoid hematoma: 16 cases (1993-2005).. J Am Vet Med Assoc 2012 Jun 1;240(11):1338-44.
    pubmed: 22607602doi: 10.2460/javma.240.11.1338google scholar: lookup
  27. Tremaine WH. Complications associated with dental and paranasal sinus surgery. Proceedings of the AAEP Focus Meeting Indianapolis, IN.
  28. 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 May;33(3):274-82.
    pubmed: 11352350doi: 10.2746/042516401776249615google scholar: lookup
  29. 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 May;33(3):283-9.
    pubmed: 11352351doi: 10.2746/042516401776249787google scholar: lookup
  30. Waite A, Gilliver SC, Masterson GR, Hardman MJ, Ashcroft GS. Clinically relevant doses of lidocaine and bupivacaine do not impair cutaneous wound healing in mice.. Br J Anaesth 2010 Jun;104(6):768-73.
    pmc: PMC2867659pubmed: 20418532doi: 10.1093/bja/aeq093google scholar: lookup
  31. Woodford NS, Lane JG. Long-term retrospective study of 52 horses with sinunasal cysts.. Equine Vet J 2006 May;38(3):198-202.
    pubmed: 16706271doi: 10.2746/042516406776866372google scholar: lookup
  32. Zeren S, Kesici S, Kesici U, Isbilir S, Turkmen UA, Ulusoy H, Karpuz V, Ozcan O, Polat E, Ipcioglu OM, Sari MK. Effects of levobupivacaine on wound healing.. Anesth Analg 2013 Feb;116(2):495-9.
    pubmed: 23302982doi: 10.1213/ane.0b013e318273f48egoogle scholar: lookup

Citations

This article has been cited 1 times.
  1. Jamieson CA, Baillie SL, Johnson JP. Blood Transfusion in Equids-A Practical Approach and Review. Animals (Basel) 2022 Aug 23;12(17).
    doi: 10.3390/ani12172162pubmed: 36077883google scholar: lookup