Diagnosis and Surgical Treatment of Idiopathic Primary Sino-Nasal Obstruction in Miniature Horse Breeds: Long-Term Follow-Up of Seven Cases.

Lieven Vlaminck,Els Raes,Katrien Vanderperren,Elke Pollaris,W Henry Tremaine

doi:10.3389/fvets.2021.680150

Abstract

Idiopathic sino-nasal obstruction resulting in retention of large amounts of liquid in the paranasal sinus compartments was diagnosed in seven young (2. 2 ± 0.7 years) miniature-breed horses based on clinical, endoscopic, radiographic, and CT scan examinations. The most prevalent clinical signs included decreased or no airflow from the nostril(s) (7/7) and nasal discharge (6/7). The problem presented bilaterally in six of seven cases. An alternative sino-nasal communication was created through bone flap osteotomy surgery and perforation of the ventromedial floor of the dorsal conchae in all cases, followed by fixation of silicone irrigation tubes/Foley catheters in six of seven cases to keep the newly created ostium patent. This resulted in long-term resolution of the problem with good cosmetic appearance in all animals following a median period of 19 months. Premature loss of fixed tubes was reported in three cases.

Highlights

A variety of sino-nasal pathological conditions in horses have been well-described
We describe the clinical symptoms, diagnostic work-up, and long-term follow-up of seven comparable cases of sino-nasal obstruction treated by bone flap surgery and restored drainage toward the nasal cavity
Idiopathic sino-nasal obstruction is very rarely encountered in horses

Summary

Introduction

A variety of sino-nasal pathological conditions in horses have been well-described. Common diseases include primary and secondary sinusitis [1,2,3], paranasal sinus cysts [4], progressive ethmoid hematoma [5, 6], and more rarely encountered sinus neoplasia [7, 8]. Other pathologies often require surgical interventions such as transnasal sinus approaches or external trephination, sinoscopy, or sinusotomy to restore nasomaxillary mucus drainage or to deal with the encountered pathology. A seldomly reported sinus pathology in horses is sinus mucocele. Mucoceles are believed to develop following obstruction of the nasomaxillary aperture between sinus and the nasal cavity. Progressive deformation of the surrounding structures is the result of continuous production and accumulation of mucus in the isolated sinus compartments.

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