Endoscopic examination and treatment of paranasal sinus disease in 16 horses

Sixteen horses with suspected paranasal sinus disease had endoscopic examination of the paranasal sinuses with a 4.0 mm arthroscope either while standing and sedated (14 horses) or under general anesthesia (two horses). Endoscopic diagnosis included sinusitis (four horses), sinus cyst (three horses), hemorrhage (three horses), neoplasia (three horses), and tooth root abnormalities (two horses). No abnormalities were detected in one horse. Endoscopic findings concurred with the radiographic findings in 13 horses (81%). Samples of sinus contents for bacteriologic (eight horses) and histologic examinations (five horses) were obtained using sinus endoscopy. Diagnostic sinus endoscopy was combined with debridement, lavage, and suction as a therapeutic technique in 10 horses. In three horses, sinus exploration was performed after diagnostic endoscopy confirmed sinus disease, whereas in three horses, further therapy was not recommended after sinus endoscopy. Clinical signs of sinus disease resolved in 11 horses (69%) overall and in eight of 10 horses (80%) with sinusitis, cyst formation, or hemorrhage using endoscopic techniques alone. Mild, local subcutaneous emphysema occurred at the portal sites in all horses, but healing occurred without additional complications. Iatrogenic damage to sinus structures occurred in one horse. Sinus endoscopy was useful in the diagnosis and management of paranasal sinus disease and avoided the need for exploratory sinusotomy in some horses.