ISSN 2398-2977      

Paranasal sinus: bone flap technique - standing surgery

pequis

Introduction

  • Standing sinus surgery offers an alternative to sinus surgery under general anesthesia Paranasal sinus: bone flap technique:
  • 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, mass debulking, 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, mass debulking, 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 sinonasal fenestration or for dental repulsion Teeth: repulsion.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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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 Z & Dixon P M (2014) Standing equine sinus surgery. Vet Clin Equine Pract 30 (1), 45-62 PubMed.
  • Dixon P M & O'Leary J M (2012) A review of equine paranasal sinusitis: medical and surgical treatments. Equine Vet Ed 24 (3), 143-158 WileyOnline.
  • Tatarniuk D M, Bell C & Carmalt J L (2010) A description of the relationship between the nasomaxillary aperture and the paranasal sinus system of horses. Vet J 186 (2), 216-220 PubMed.
  • 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.
  • Schumacher J & Perkins J (2005) Surgery of the paranasal sinuses performed with the horse standing. Clin Tech Equine Pract 4 (2), 188-194 VetMedResource.

Other sources of information

  • Nickels F A (2012) Chapter 43 - Nasal Passages and Paranasal Sinuses. In: Equine Surgery. 4th edn. Eds: Auer J A & Stick J A. W B Saunders, USA. pp 557-568.
  • Tremaine W H & Freeman D E (2007) Disorders of the Paranasal Sinuses. In: Equine Respiratory Medicine and Surgery. Saunders Elsevier, USA. pp 403-404.

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