Transnasal, Endoscopically Guided Skull-Based Surgery by Pharyngotomy for Mass Removal from the Sphenopalatine Sinus in a Horse.

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.