Sinoscopic treatment of rostral maxillary and ventral conchal sinusitis in 60 horses.

The research article explores the use of sinoscopy for detecting and treating sinus diseases in horses, specifically in the ventral conchal sinus (VCS) and rostral maxillary sinus (RMS). It reports that sinoscopy, performed through a conchofrontal sinus (CFS) portal with ventral conchal bulla (VCB) fenestration, can effectively diagnose and remedy many sinus disorders.

Research Methodology

• The study involved a case series methodology where 60 horses with suspected paranasal sinus disease were evaluated.
• These horses were examined through sinoscopy via a conchofrontal sinus (CFS) portal, with an incision made into the ventral conchal bulla (VCB) – a structure in the equine nasal cavity.
• The study also incorporated the use of other sinus approaches and diagnostic tests. These included oral examination, computed tomography (CT), radiography, scintigraphy, as well as endoscopic inspection of the upper portion of the respiratory tract.

Study Results

• The conchofrontal sinus (CFS) approach, in 88% cases (53 horses), allowed an adequate inspection of the rostral maxillary sinus (RMS) and the ventral conchal sinus (VCS).
• Fenestration of the ventral conchal bulla (VCB) led to a hemorrhage that obstructed examination of the RMS and/or VCS in 21% cases (12 horses).
• Lesions were observable in all horses diagnosed with neoplasia (an abnormal growth), sinus cysts, and progressive ethmoidal hematomas (a rare, benign, blood-filled cystic mass).
• Endoscopy proved diagnostically beneficial in around 82% of horses with primary sinusitis, i.e., inflammation of the sinuses due to bacterial infection.
• In cases of dental sinusitis, additional diagnostic methods were mostly needed to confirm the diagnosis.

Study Conclusions

• CLR with VCB fenestration emerged as a minimally invasive method giving consistent access to the RMS and VCS. It enabled diagnosis and treatment of numerous sinus disorders.
• The technique was found beneficial for endoscopically-guided treatment coupled with sinus lavage, a cleaning process to treat sinus infections.
• Several diseases impacting the RMS and VCS can be diagnosed and treated endoscically using the CFS approach coupled with VCB fenestration. This avoids the need for invasive osteoplastic sinus surgery, which comes with multiple inherent risks and complications.