Transnasal, Endoscopically Guided Skull-Based Surgery by Pharyngotomy for Mass Removal from the Sphenopalatine Sinus in a Horse.
Abstract: To report a transnasal, endoscopically guided ventral surgical approach for accessing the cranial and caudal segments of the sphenopalatine sinus for mass removal in a horse. Methods: Case report. Methods: Adult horse with acute onset blindness referable to a soft tissue mass within the sphenopalatine sinus. Methods: A 7-year-old Warmblood gelding presented with a history of running into a fence and falling. No neurologic signs were identified at initial examination but acute blindness was noted 3 weeks later. On computed tomography (CT) the sphenopalatine sinus was filled with a large homogeneous mass with poor contrast enhancement that extended dorsally with thinning to the dorsal cortex of the sphenoid bone, just rostral to the entrance of the optic canals into the cranial cavity. Surgical access to the sphenopalatine sinus was achieved using a transnasal, endoscopically guided ventral pharyngotomy approach and the mass lesion was removed. A presumptive diagnosis of chondroma was made based on histopathology. The horse recovered well from surgery, and although it has not regained vision as of 6.5 years postoperatively, the disease has not progressed. Conclusions: Transnasal, endoscopically-guided ventral surgical access to the sphenopalatine sinus is possible in horses and may improve access in horses with disease extending caudally beyond the palatine portion of the sinus. Use of smaller diameter or specialized instruments, such as various endoscopic bone cutting instruments, and CT image guidance may improve sinus access by this route.
© Copyright 2016 by The American College of Veterinary Surgeons.
Publication Date: 2016-10-12 PubMed ID: 27731516DOI: 10.1111/vsu.12573Google Scholar: Lookup
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Summary
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This research discusses a transnasal, endoscopically guided surgical method used for removal of a mass from a horse’s sphenopalatine sinus. The case study presents a 7-year-old horse, showing blindess due to a mass within the sinus, which hasn’t regained its sight even after 6.5 years post-operation.
Case Background
- The animal in this research is a 7-year-old Warmblood gelding horse. It initially suffered an accident where it ran into a fence and fell.
- Three weeks following the accident, the horse developed acute blindness, prompting an in-depth examination involving computed tomography (CT).
Computed Tomography (CT) Analysis
- CT investigation revealed that the sphenopalatine sinus was occupied by a large homogeneous mass. This mass poorly contrasted and extended towards the dorsal cortex of the sphenoid bone, just ahead of the optic canals’ entrance into the cranial cavity.
- The size and positioning of this mass within the horse’s sinus prompted the decision to undergo surgery for its removal.
Surgical Approach and Findings
- To remove the mass, a transnasal, endoscopically guided ventral pharyngotomy method was used to access the sphenopalatine sinus.
- Following the surgery, presumptive diagnosis based on histopathology suggested the mass was a chondroma.
Post-Surgery Observation
- Despite the successful operation, the horse did not regain its sight even after 6.5 years.
- The good news, however, was that the disease did not show any signs of progress during this time.
Conclusion and Recommendations
- The study concluded that a transnasal, endoscopically guided ventral surgical approach could be an efficient method for accessing equine sphenopalatine sinuses, specifically where the disease extends caudally beyond the palatine portion of the sinus.
- The research also suggests that using smaller diameter or specialized tools, such as various endoscopic bone-cutting instruments, under the guidance of CT images, could further enhance sinus access using this surgical route.
Cite This Article
APA
Radcliffe RM, Messiaen Y, Irby NL, Divers TJ, Dewey CW, Mitchell KJ, Schnabel LV, Bezuidenhout AJ, Scrivani PV, Ducharme NG.
(2016).
Transnasal, Endoscopically Guided Skull-Based Surgery by Pharyngotomy for Mass Removal from the Sphenopalatine Sinus in a Horse.
Vet Surg, 45(8), 1108-1117.
https://doi.org/10.1111/vsu.12573 Publication
Researcher Affiliations
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York. rmr45@cornell.edu.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York.
MeSH Terms
- Animals
- Chondroma / diagnosis
- Chondroma / surgery
- Chondroma / veterinary
- Endoscopy / veterinary
- Horse Diseases / diagnosis
- Horse Diseases / surgery
- Horses
- Male
- Pharyngectomy / methods
- Pharyngectomy / veterinary
- Skull / surgery
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