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Paranasal sinus: drainage ostia - enlargement

pequis

Introduction

  • The paranasal sinuses are large but drainage through the nasomaxillary opening into the middle nasal meatus is through a long, compressed slit and is generally poor.
  • The rostral maxillary sinus and ventral conchal sinus have a separate drainage route to the rest of the paranasal sinuses.
  • Part of the surgical treatment of paranasal sinus disease may include establishing increased drainage by enlargement or augmentation of the drainage ostia.

Uses

Advantages

  • Permanently improves paranasal sinus drainage.
  • Allows for packing of sinuses with exit out nostril, preventing need to reopen flap to remove packaging.

Disadvantages

  • Requires bone flap procedure Paranasal sinus: bone flap technique to gain adequate exposure to establish drainage.
  • Often associated with profuse hemorrhage.
  • Some cases will have a permanent low grade inflammation of sinuses following this procedure - may have a permanent low grade nasal discharge.

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

  • Usually good with permanently effective increased drainage.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Kološ F, Bodeček Š & Žert Z (2017) Trans-endoscopic diode laser fenestration of equine conchae via contralateral nostril approach. Vet Surg 46 (7), 915-924 PubMed.
  • 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.
  • Dixon P M, Parkin T D, Collins N et al (2012) Equine paranasal sinus disease: a long-term study of 200 cases (1997–2009): ancillary diagnostic findings and involvement of the various sinus compartments. Equine Vet J 44 (3), 267-271 PubMed.

Other sources of information

  • Beard W (2014) Frontonasal and Maxillary Sinusotomy Performed Under General Anesthesia. In: Advances in Equine Upper Respiratory Surgery​. Ed: Hawkins J. Wiley. pp 177-183
  • 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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