Equis ISSN 2398-2977

Paranasal sinus: bone flap technique - standing surgery

Contributor(s): Safia Barakzai, Jessica A Kidd-Millar, Jessica A Kidd

Introduction

  • Standing sinus surgery offers an alternative to sinus surgery under general anesthesia   Paranasal sinus: bone flap technique  :
    • The procedure is done using sedation   Anesthesia: standing chemical restraint  and local anesthesia   Anesthesia: local - overview  .
    • The method described here involves making a bone flap in the frontal bone, which is then discarded.
    • Other techniques for standing sinus surgery may preserve the flap and secure it in place with cerclage wires.
  • A thorough knowledge of the relevant anatomy is essential.
  • The procedure can be used for diagnostic and therapeutic reasons.
  • The most commonly treated conditions are primary sinus empyema, sinus cysts, and progressive ethmoid hematomas.

Uses

  • The procedure can be used for diagnostic and therapeutic reasons.
  • The most commonly treated conditions are primary sinus empyema, sinus cysts, and progressive ethmoid hematomas.

Advantages

  • No risk of general anesthesia.
  • Better orientation of the anatomy with less engorgement from recumbency.
  • No cost of general anesthesia.
  • Less blood loss than in a recumbent horse.
  • Less engorgement of anatomical structures.

Disadvantages

  • Requires a thorough knowledge of the anatomy of the head and the sinuses:
    • Inadequate anatomical knowledge can result in severe hemorrhage necessitating a GA and tamponade packing of the sinuses.
    • Inadequate knowledge of the procedure can   →   damage of the nasolacrimal duct or infra-orbital canal.
  • Not recommended for treatment of neoplasia for sinunasal fenestration or for dental repulsion   Teeth: repulsion  .

Requirements

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Preparation

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Procedure

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Aftercare

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Prognosis

  • Depends on the underlying pathology but generally good for resolution and very good for a diagnosis.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Barakzai S (2008) Standing sinus surgery in the horse: indications, techniques and complications. In Pract 30 (5), 252-259 VetMedResource.
  • Quinn G C, Kidd J A & Lane J G (2005) Modified frontonasal sinus flap surgery in standing horses: surgical findings and outcomes of 60 cases. Equine Vet J 37 (2), 138-142 PubMed.


ADDED