Paranasal sinus surgery through a frontonasal flap in sedated, standing horses.

The research article discusses the experience of performing paranasal sinus surgery on standing, sedated horses through a frontonasal flap, highlighting its safety and potential advantages over general anesthesia.

Methods

• The research focused on the surgical treatment of 10 adult horses with a naturally occurring ailment of the paranasal sinuses.
• An established method followed for the surgery, involving the use of local anesthetic injected subcutaneously along a designed incision line over the conchofrontal sinus of the horses. This anesthetic was additionally instilled into the sinuses via a small hole created in the frontal bone.
• The surgical procedure involved the creation of a 3-sided, rectangular, cutaneous incision that extended through the periosteum over the frontal and nasal bones. The incision was then extended into the conchofrontal sinus using a bone saw, and the base of the flap, following the midline of the face, was fractured.
• Once the sinuses were accessed, they were explored and any identified disease was treated. The flap was then repositioned and both the subcutaneous tissue and skin were sutured separately.

Results

• The horses showcased very few signs of discomfort during the creation of the bone flap and in the disease treatment phase.
• A variety of diseases were identified and treated, including inspissated exudate in the ventral conchal sinus, feed and exudate throughout the sinuses, occlusion of the nasomaxillary aperature, a polyp, an osteoma, and a progressive ethmoidal hematoma.

Conclusions

• The results showcased that in specific cases, surgery of the paranasal sinuses could be safely executed on horses that are sedated and standing via a frontonasal bone flap.
• The advantage of performing this surgery with the horse standing and sedated, as opposed to anesthetized, is that it removes the potential risks and the financial cost associated with general anesthesia.