Canaliculosinostomy as a Long-Term Treatment of Seven Horses for Permanent Obstruction of the Nasolacrimal Duct.

Summary

# Editorial Summary: Canaliculosinostomy for Nasolacrimal Duct Obstruction Permanent nasolacrimal duct obstruction is a frustrating condition in equine practice, often resulting in chronic epiphora that is unresponsive to conventional medical management. Brink and Schumacher presented a seven-horse case series using canaliculosinostomy—a surgical technique that creates an alternative drainage pathway by diverting lacrimal secretions directly into the maxillary sinus—to address this problem. The procedure involved progressively dilating the ventral lacrimal punctum and canaliculus, then placing a tube through the dilated canaliculus into the caudal maxillary sinus, with the tube subsequently tunnelled to the forehead for temporary exteriorisation during the initial healing phase (5–6 weeks). Of the seven horses treated, five achieved complete resolution of epiphora whilst two showed significant improvement, with the procedure performed successfully under sedation alone without general anaesthesia. For practitioners managing horses with intractable nasolacrimal obstruction, this technique offers a viable surgical alternative that provides both functional restoration and acceptable cosmetic results, particularly when standard approaches such as flushing, probing, or medication have failed.

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Key Findings

• •Canaliculosinostomy successfully resolved epiphora in 5 of 7 horses (71%) with permanent nasolacrimal duct obstruction
• •Procedure can be performed under sedation without general anesthesia
• •Temporary tubing diversion into maxillary sinus provided good functional and cosmetic outcomes
• •Temporary tube placement for 5-6 weeks achieved durable resolution or improvement of clinical signs

Conditions Studied