Standing excision of the nasal septum of 12 horses.

Overview

• This study describes a technique for removing the nasal septum in standing horses using sedation and local anesthesia.
• It also reports the complications encountered and the outcomes of 12 horses treated with this method.

Background and Purpose

• Diseases of the nasal septum in horses sometimes require surgical removal (excision) of the septum.
• Traditionally, this surgery might be performed with the horse under general anesthesia and recumbent (lying down), which can be risky and expensive.
• This study aims to describe a standing surgical technique that avoids general anesthesia and to evaluate its safety and effectiveness.

Methods

• The study is retrospective, reviewing cases of 12 horses with nasal septum disease that underwent excision.
• Each horse was sedated and kept standing during the procedure.
• The surgical technique involved:
  • Performing a rhinotomy (an incision in the nasal passage) in all horses for access.
  • Performing a laryngotomy (an incision in the larynx area) in six horses to help place three loops of obstetrical wire that would guide the septal incisions.
• Various anesthesia techniques were used to minimize pain:
  • Local anesthetic was injected subcutaneously at the rhinotomy and laryngotomy sites.
  • Topical local anesthetic was instilled into both nasal passages to desensitize the septum surface.
  • Further, in 11 horses, maxillary nerve blocks were performed to numb the nerves supplying the region.
  • In 3 of these 11 horses, local anesthetic was also injected beneath the septal mucosa at the rhinotomy site for extra pain control.

Results

• All 12 horses had their nasal septums resected successfully and safely while standing.
• The amount of bleeding during surgery appeared less than what is typically observed when the horse is recumbent under general anesthesia.
• Outcomes for the horses were generally positive:
  • Eleven of the horses returned to their original intended use after surgery.
  • One horse died, presumably due to a complication related to the maxillary nerve block anesthesia.

Conclusions

• Excision of the nasal septum in horses can be done safely while the horse is standing using sedation combined with local, topical, and regional anesthesia.
• This standing technique avoids the risks and costs associated with general anesthesia and recumbent surgery.
• Care must be taken with regional nerve blocks as they may carry risks, as seen in the one fatality.

Implications

• This standing excision technique offers a viable surgical approach for horses needing nasal septum removal without exposing them to general anesthesia.
• Veterinarians should consider this method especially when trying to reduce anesthesia-related risks and costs.
• Further research could help optimize anesthesia protocols and reduce complications.