Surgical enlargement of the nasomaxillary aperture and transnasal conchotomy of the ventral conchal sinus: Two surgical techniques to improve sinus drainage in horses.
Abstract: To evaluate 2 surgical techniques for establishing and/or improving paranasal sinus drainage in cadaver heads and horses with sinusitis and evaluate the feasibility of postoperative transnasal sinus endoscopy. Methods: Ex vivo study (equine cadaver heads) and case series. Methods: Nine adult equine cadaver heads and 8 horses with recurrent sinusitis. Methods: For the ex vivo study, the following procedures were performed on 9 cadaver heads: preoperative and postoperative computed tomography (heads 1-6), endoscopy-guided transnasal conchotomy of the ventral conchal sinus (TCVCS) and surgical enlargement of the nasomaxillary aperture (SENMAP) on opposite sides (heads 1-3), combined TCVCS and SENMAP on both sides (heads 4-9), evaluation of sinus drainage before and after surgery (heads 7-9), and postoperative transnasal endoscopy (heads 4-9). For the case series, 8 horses with secondary sinusitis were treated in standing position with SENMAP and/or TCVCS and postoperative transnasal endoscopy. Results: Sinonasal communications were successfully created in all cadavers and affected live horses. Transnasal endoscopy of all sinuses except the middle conchal sinus was possible in heads 4-9 and in all clinical cases. Sinus drainage was improved (P = .028) by combining techniques. Blood loss in live horses ranged from 0.5-5.5 L (1.95 ± 1.5) per horse. Sinusitis resolved in all affected horses during follow-up of 3.2-25.5 months (13.5 ± 8.5). Conclusions: Transnasal conchotomy of the ventral conchal sinus and SENMAP consistently created large sinonasal communications, facilitating sinus endoscopy and improving sinus drainage. Conclusions: Transnasal conchotomy of the ventral conchal sinus and SENMAP are viable options to treat horses with sinusitis and anatomical obstructions of the sinonasal communications.
© 2019 The Authors. Veterinary Surgery published by Wiley Periodicals, Inc. on behalf of American College of Veterinary Surgeons.
Publication Date: 2019-04-09 PubMed ID: 30968454PubMed Central: PMC6767416DOI: 10.1111/vsu.13207Google Scholar: Lookup
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- Journal Article
Summary
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The paper presents an evaluation of two surgical techniques that aim to improve sinus drainage in horses suffering from sinusitis. The techniques were tested on cadaver heads and live horses, and both appeared to effectively create larger sinus passageways, improve drainage, and facilitate endoscopy.
Background
- The study was carried out to evaluate the efficacy of two surgical methods: the transnasal conchotomy of the ventral conchal sinus (TCVCS) and the surgical enlargement of the nasomaxillary aperture (SENMAP). These methods are designed to improve sinus drainage in horses suffering from sinusitis.
- The techniques were evaluated both on cadaver heads (ex vivo), and on live horses that had been diagnosed with recurrent sinusitis.
Method
- Both procedures were performed on nine adult equine cadaver heads, while a smaller number of horses, eight in total, with secondary sinusitis were treated with SENMAP and/or TCVCS.
- For the ex vivo study, a combination of pre-and postoperative computed tomography, endoscopy-guided TCVCS and SENMAP, assessment of sinus drainage before and after surgery, and postoperative transnasal endoscopy were undertaken.
- The same surgical techniques were used for the live horses, with the addition of postoperative transnasal endoscopy.
Results
- The results indicated successful creation of larger sinonasal communications in all cadavers and live horses treated.
- Postoperative transnasal endoscopy of all sinuses (except the middle conchal sinus) was achieved in the specified cadaver heads and in all the cases involving live horses.
- Sinus drainage was improved significantly with the combination of techniques, and blood loss in live horses was kept to a minimum.
- The surgical strategies resulted in the resolution of sinusitis in all treated horses over a follow-up period ranging from 3.2 to 25.5 months.
Conclusion
- This research concluded that TCVCS and SENMAP were consistent in creating larger sinonasal communications, improving sinus drainage, and facilitating sinus endoscopy.
- The study suggests that transnasal conchotomy of the ventral conchal sinus and SENMAP are viable options for treating horses with sinusitis and anatomical obstructions of the sinonasal passageways.
Cite This Article
APA
Bach FS, Böhler A, Schieder K, Handschuh S, Simhofer H.
(2019).
Surgical enlargement of the nasomaxillary aperture and transnasal conchotomy of the ventral conchal sinus: Two surgical techniques to improve sinus drainage in horses.
Vet Surg, 48(6), 1019-1031.
https://doi.org/10.1111/vsu.13207 Publication
Researcher Affiliations
- Equine University Clinic, University of Veterinary Medicine, Vienna, Austria.
- Clinical Unit of Diagnostic Imaging, University of Veterinary Medicine, Vienna, Austria.
- Clinical Unit of Diagnostic Imaging, University of Veterinary Medicine, Vienna, Austria.
- VetCore Facility for Research, University of Veterinary Medicine, Vienna, Austria.
- Equine University Clinic, University of Veterinary Medicine, Vienna, Austria.
MeSH Terms
- Animals
- Cadaver
- Craniotomy
- Drainage
- Endoscopy / veterinary
- Horse Diseases / surgery
- Horses
- Paranasal Sinuses / surgery
- Sinusitis / surgery
- Sinusitis / veterinary
- Tomography, X-Ray Computed / veterinary
Conflict of Interest Statement
The authors declare no conflicts of interest related to this report.
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Citations
This article has been cited 2 times.- Jehle MC, Biermann NM, Haltmayer E. Trephination versus Minimally Invasive Transnasal Approaches for the Diagnosis and Treatment of Sinus Disease in Horses. Vet Sci 2022 Jul 1;9(7).
- Vlaminck L, Pollaris E, Vanderperren K, Tremaine WH, Raes E. Diagnosis and Surgical Treatment of Idiopathic Primary Sino-Nasal Obstruction in Miniature Horse Breeds: Long-Term Follow-Up of Seven Cases. Front Vet Sci 2021;8:680150.
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