A large frontonasal bone flap for sinus surgery in the horse

Area of Science:

• Veterinary Surgery
• Equine Medicine
• Surgical Oncology

Background:

• Diseases of the equine paranasal sinuses require effective surgical intervention.
• Previous surgical techniques may offer limited access to all affected sinus compartments.
• The frontonasal bone flap is a potential surgical approach for complex sinus pathologies.

Purpose of the Study:

• To evaluate the efficacy and outcomes of a large frontonasal bone flap technique for treating diverse diseases within the equine paranasal sinuses.
• To assess the surgical accessibility and complication rates associated with this flap technique.

Main Methods:

• A large frontonasal bone flap was surgically created in 14 horses.
• The flap was designed for maximal width within the nasolacrimal duct boundaries to access frontal, maxillary, and conchal sinuses.
• Surgical procedures addressed conditions including ethmoid hematomas, sinus cysts, fungal granulomas, tumors, and infections.

Main Results:

• The frontonasal flap provided extensive access, enabling the removal of diffuse and localized lesions.
• Ten out of 14 horses recovered successfully and returned to their intended use with no recurrence of primary issues.
• Complications included four cases of euthanasia due to primary disease or post-surgical complications, and four instances of treatable skin suture abscesses.

Conclusions:

• The frontonasal bone flap technique offers superior access to equine paranasal sinuses compared to previously described methods.
• This technique is effective for treating a range of sinus pathologies, with a favorable prognosis for most treated horses.
• Further investigation into optimizing this surgical approach for complex equine sinus disease is warranted.