Trephination versus Minimally Invasive Transnasal Approaches for the Diagnosis and Treatment of Sinus Disease in Horses.
Abstract: This retrospective case series aims to highlight the advantages and disadvantages of different treatment options for sinus disease in horses, with a special focus on surgical approaches. The medical records of 25 horses with sinusitis which presented to the equine hospital, Vetmeduni Vienna, between August 2020 and January 2022 were analysed. In 11 cases, conservative treatment by the transnasal endoscopic lavage of the affected sinuses through the sinonasal channel or through a developed, pre-existing sinonasal fistula was performed. In the remaining 14 cases, openings into the sinus for subsequent lavage were surgically created either via classical trephination/bone flaps (8) or by transnasal endoscopically guided minimally invasive approaches (8). In some cases (2), a combination of classical extra-nasal and minimally invasive transnasal approaches was required. The minimally invasive techniques used were comprised of laser surgery (3), electrosurgery (3) and balloon sinoplasty (2). The sinusitis and underlying diseases were successfully treated in all of the horses until hospital discharge. Long-term follow-up could be obtained only from a small number of patients due to the temporal proximity (the study began two years ago) to their initial discharge from the hospital, but they showed the continuous resolution of clinical signs in all cases in which follow up data were available. The results of this case series indicate that if surgical intervention is required, minimally invasive techniques appear to be a promising and potentially cheaper alternative to classical extra-nasal approaches for the treatment of sinus disease in selected cases. In the future, the use of these techniques should be considered more commonly with the broader availability of improved endoscopes and instruments. Additionally, by using small-diameter endoscopes, the need for any surgical intervention might be significantly reduced in many cases.
Publication Date: 2022-07-01 PubMed ID: 35878351PubMed Central: PMC9323710DOI: 10.3390/vetsci9070334Google Scholar: Lookup
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Summary
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The research article focuses on comparing traditional and minimally invasive surgical methods for the treatment of sinus disease in horses, concluding that minimally invasive techniques could be a cost-effective and promising alternative in selected cases.
Overview of the Research
- This research is a retrospective case series, aiming to identify the merits and demerits of different treatments for sinus disease in horses. It carefully analyzes the medical records of 25 equine patients diagnosed with sinusitis from August 2020 to January 2022 at the Vetmeduni Vienna equine hospital.
- Out of these 25 cases, 11 underwent conservative treatment using transnasal endoscopic lavage – a procedure where the sinuses are rinsed through the sinonasal channel or a pre-existing sinonasal fistula. For the remaining 14 cases, sinus openings were surgically created for subsequent lavage either via traditionalbonetrepination/bone flaps (an old surgical technique that involves drilling a hole into the skull) or minimally invasive methods guided by transnasal endoscopy.
- Occasionally, a mix of traditional and minimally invasive approaches was required. The minimally invasive techniques used included laser surgery, electrosurgery, and balloon sinoplasty.
Results of the Research
- All horses in the study were successfully treated for sinusitis and any underlying disease by the time of their hospital discharge. Long-term follow-ups could only be conducted on a small number of patients due to the temporal proximity of their initial discharge, but these showed continuing resolution of clinical signs.
- The research suggests that minimally invasive techniques could be a compelling, potentially more cost-effective choice compared to traditional extra-nasal approaches in treating sinus disease in select cases.
Future Consideration and Conclusion
- As endoscopes and instruments continue to improve in the future, researchers suggest the more common usage of minimally invasive techniques. The study also indicates that by using small-diameter endoscopes, the need for surgical intervention may be significantly reduced in several cases.
- This research could serve as a basis for more comprehensive studies in the future and potentially redefine the standard approach to the treatment of equine sinusitis.
Cite This Article
APA
Jehle MC, Biermann NM, Haltmayer E.
(2022).
Trephination versus Minimally Invasive Transnasal Approaches for the Diagnosis and Treatment of Sinus Disease in Horses.
Vet Sci, 9(7), 334.
https://doi.org/10.3390/vetsci9070334 Publication
Researcher Affiliations
- Equine Hospital, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1220 Wien, Austria.
- Equine Hospital, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1220 Wien, Austria.
- Equine Hospital, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1220 Wien, Austria.
Grant Funding
- Open Access Funding by the University of Veterinary Medicine Vienna.
Conflict of Interest Statement
The authors declare no conflict of interest.
References
This article includes 28 references
- Dixon PM, Froydenlund T, Luiti T, Kane-Smyth J, Horbal A, Reardon RJ. Empyema of the nasal conchal bulla as a cause of chronic unilateral nasal discharge in the horse: 10 cases (2013-2014).. Equine Vet J 2015 Jul;47(4):445-9.
- Tremaine WH, Dixon PM. A long-term study of 277 cases of equine sinonasal disease. Part 1: details of horses, historical, clinical and ancillary diagnostic findings.. Equine Vet J 2001 May;33(3):274-82.
- Dixon PM, Parkin TD, Collins N, Hawkes C, Townsend N, Tremaine WH, Fisher G, Ealey R, Barakzai SZ. Equine paranasal sinus disease: a long-term study of 200 cases (1997-2009): treatments and long-term results of treatments.. Equine Vet J 2012 May;44(3):272-6.
- Claffey EF, Ducharme NG. Equine Nasal Endoscopy: Treating Bullae Disease and Sinus Disease.. Vet Clin North Am Equine Pract 2020 Dec;36(3):659-669.
- Manso-Díaz G, García-López J.M., Maranda L, Taeymans O. The role of head computed tomography in equine practice. Equine Vet. Educ. 2015;27:136–145.
- Manso-Díaz G, Taeymans O, García-López J.M., Weller R. Application and indications of magnetic resonance imaging and computed tomography of the equine head. Equine Vet. Educ. 2021;33:31–46.
- Schumacher J, Dutton DM, Murphy DJ, Hague BA, Taylor TS. Paranasal sinus surgery through a frontonasal flap in sedated, standing horses.. Vet Surg 2000 Mar-Apr;29(2):173-7.
- Tremaine WH, Dixon PM. A long-term study of 277 cases of equine sinonasal disease. Part 2: treatments and results of treatments.. Equine Vet J 2001 May;33(3):283-9.
- Quinn GC, Kidd JA, Lane JG. Modified frontonasal sinus flap surgery in standing horses: surgical findings and outcomes of 60 cases.. Equine Vet J 2005 Mar;37(2):138-42.
- Perkins JD, Windley Z, Dixon PM, Smith M, Barakzai SZ. Sinoscopic treatment of rostral maxillary and ventral conchal sinusitis in 60 horses.. Vet Surg 2009 Jul;38(5):613-9.
- Barakzai SZ, Dixon PM. Standing equine sinus surgery.. Vet Clin North Am Equine Pract 2014 Apr;30(1):45-62.
- Bach FS, Böhler A, Schieder K, Handschuh S, Simhofer H. 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 2019 Aug;48(6):1019-1031.
- Pigott J. Equine Sinus Surgery.. Vet Clin North Am Equine Pract 2020 Dec;36(3):613-639.
- Perkins JD, Bennett C, Windley Z, Schumacher J. Comparison of sinoscopic techniques for examining the rostral maxillary and ventral conchal sinuses of horses.. Vet Surg 2009 Jul;38(5):607-12.
- Pouyet M, G Bonilla A. Validation of a 2-mm videoendoscope for the evaluation of the paranasal sinuses with a minimally invasive technique.. Vet Surg 2020 Jun;49 Suppl 1:O60-O70.
- Dixon PM, Kennedy R, Poll K, Barakzai S, Reardon RJM. A long-term study of sinoscopic treatment of equine paranasal sinus disease: 155 cases (2012-2019).. Equine Vet J 2021 Sep;53(5):979-989.
- Palozzo A, Celani G, Varasano V, Marruchella G, Petrizzi L. Surgical Debulking and TransEndoscopic Noncontact Diode Laser Application for Treating a Sinonasal Myxoma in a Horse.. J Equine Vet Sci 2021 Mar;98:103354.
- Harps O, Ohnesorge B, Deegen E. Transendoscopic fenestration of the ventral nasal concha in the horse for the therapy of primary sinusitis—A case report. Pferdeheilkunde 1996;12:99–104.
- Bell C, Tatarniuk D, Carmalt J. Endoscope-guided balloon sinuplasty of the equine nasomaxillary opening.. Vet Surg 2009 Oct;38(7):791-7.
- Morello SL, Parente EJ. Laser vaporization of the dorsal turbinate as an alternative method of accessing and evaluating the paranasal sinuses.. Vet Surg 2010 Oct;39(7):891-9.
- Kološ F, Bodeček Š, Žert Z. Trans-endoscopic diode laser fenestration of equine conchae via contralateral nostril approach.. Vet Surg 2017 Oct;46(7):915-924.
- Kolos F, Bodecek S, Vyvial M, Krisova S, Mrackova M. Transnasal endoscopic treatment of equine sinus disease in 14 clinical cases. Equine Vet. Educ. 2020;32:E116–E124.
- Perez JA, Hutton AE, Cudd SK, Brown JA. Standing trans-nasal endoscopic guided CO(2) laser fenestration of the palatine bone to access the sphenopalatine sinus in a horse.. Vet Surg 2021 Aug;50(6):1350-1358.
- Staszyk C, Bienert A, Bäumer W, Feige K, Gasse H. Simulation of local anaesthetic nerve block of the infraorbital nerve within the pterygopalatine fossa: anatomical landmarks defined by computed tomography.. Res Vet Sci 2008 Dec;85(3):399-406.
- Manso-Díaz G, Taeymans O. Imaging diagnosis--nasofrontal suture exostosis in a horse.. Vet Radiol Ultrasound 2012 Sep-Oct;53(5):573-5.
- Dixon P.M.. A review of swellings of the frontal region of the equine head. Equine Vet. Educ. 2014;26:365–371.
- Verwilghen D. Help Doc: My horse turned into Frankenstein. Equine Vet. Educ. 2014;26:179–180.
- Fenner MF, Verwilghen D, Townsend N, Simhofer H, Schwarzer J, Zani DD, Bienert-Zeit A. Paranasal sinus cysts in the horse: Complications related to their presence and surgical treatment in 37 cases.. Equine Vet J 2019 Jan;51(1):57-63.
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