Removal of inspissated purulent exudate from the ventral conchal sinus of three standing horses.

The research paper discusses the diagnosis and treatment of primary paranasal sinusitis in three horses. The focus was specifically on sinusitis complicated by a hardened pus build-up in a particular sinus cavity, which was successfully treated while the horses remained standing and sedated.

Introduction to the Issue

• The paper pertains to the case of three horses diagnosed with primary paranasal sinusitis. This condition occurs when the paranasal sinuses of the horse become inflamed due to infection.
• In this case, the condition was more complex due to the inspissated purulent exudate in the ventral conchal sinus. This is a hardened accumulation of pus in a specific sinus cavity – the ventral conchal sinus.
• Two of the horses also showed partial nasal obstruction, identified as an internal anatomical irregularity in the form of an axial deviation of the ventral concha – the bone that forms the lateral wall of the nasal cavity.

Radiographic Discussion

• To further investigate the condition, radiographic imaging was employed. A mass was observed dorsal to the maxillary molars in all three horses on a lateral radiographic view. In one of the horses, this mass was also visible on the dorsoventral view – from top to bottom.
• The location and presence of this mass suggested a possible accumulation of the inspissated purulent exudate – the hardened pus.

Treatment Procedure

• In order to treat this condition, a particular procedure was followed which involved the extraction of the inspissated purulent exudate.
• The procedure involved trephination of the conchofrontal sinus and penetration of the caudal wall of the ventral conchal sinus. Trephination is a surgical intervention where a hole is drilled into the bone, in this case, the conchofrontal sinus – one of the largest sinuses in a horse’s head.
• Post trephination, the caudal wall of the ventral conchal sinus was penetrated to reach and remove the pus build-up.
• Importantly, this procedure was carried out while the horses were standing and under sedation, indicating that it was a less invasive process allowing for quick recovery.