Evaluation of a novel post operative treatment for sinonasal disease in the horse (1996–2007)

Abstract

Results of surgical treatment of sinonasal disease in horses have been reported previously; however, this paper describes the outcome of horses in which a specific post operative treatment protocol was used. The objectives of the study were to determine: 1) short- and long-term outcome; 2) complications; and 3) recurrence rates of different disease processes, when horses were treated with a specific treatment protocol. Medical records of horses presented for surgical treatment of sinonasal disease from 1996-2007 were reviewed. Results and duration of surgical exploration were recorded. Post operatively, the sinus flaps were re-opened with the horses standing and sedated. Number of horses requiring further treatment (debridement and/or lavage), median number of post operative days when the flap was re-opened, median number of times the flap was opened and median duration of hospitalisation were recorded. Short- and long-term survival and complication rates were determined. Ninety-one horses were included in the study. The sinus flaps were re-opened with the horses standing a median of 3 days post operatively. Thirty-nine horses (43%) required further treatment at this time and 89 horses (97%) survived to discharge. Incision infection was the most common complication encountered (29%). No horse required a blood transfusion. Recurrence rates were 5% for paranasal sinus cysts, 12% for progressive ethmoid haematoma and 50% for neoplasia. Rapid removal of the primary lesion followed by packing the sinuses and re-evaluating in the standing horse in a more controlled environment offers a safe and effective means to thoroughly assess and treat sinonasal disease. Surgical time, intraoperative haemorrhage, long-term complications and recurrence rates of paranasal sinus diseases treated via frontonasal or maxillary sinus flap may be reduced using this technique.