Paranasal sinus surgery through a frontonasal flap in sedated, standing horses.
Authors: Schumacher J, Dutton D M, Murphy D J, Hague B A, Taylor T S
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Standing Sinus Surgery in Horses Paranasal sinus disease in horses traditionally required general anaesthesia and recumbency, presenting significant risks and expense. Schumacher and colleagues evaluated frontonasal bone flap surgery in 10 standing, sedated horses, creating a three-sided rectangular flap through skin and periosteum before opening into the conchofrontal sinus with a bone saw and fracturing the midline base. The cohort presented with diverse pathologies—inspissated exudate (five horses), feed and exudate accumulation, nasomaxillary aperture occlusion, polyps, osteomas, and progressive ethmoidal haematomas—all of which were successfully accessed and treated, with horses demonstrating minimal discomfort throughout the procedure. Avoiding general anaesthesia substantially reduces both cardiovascular and respiratory complications, alongside anaesthetic-related mortality risk, whilst eliminating associated medication and recovery costs. For equine practitioners managing chronic sinus disease, this technique offers a viable alternative for carefully selected cases, though patient positioning, adequate sedation protocols, and meticulous local anaesthetic technique remain essential to success.
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Practical Takeaways
- •Paranasal sinus surgery in standing horses is a viable alternative to general anesthesia, reducing anaesthetic risk and cost for owners
- •The frontonasal flap approach provides adequate access to treat common sinus conditions including exudate accumulation, polyps, and hematomas
- •Horses tolerate the procedure well with only sedation and local anesthesia, making it practical for field or clinic-based surgical referral cases
Key Findings
- •Paranasal sinus surgery via frontonasal bone flap can be safely performed in standing, sedated horses without general anesthesia
- •All 10 horses showed minimal signs of discomfort during bone flap creation and surgical treatment
- •Frontonasal flap approach successfully treated six different types of paranasal sinus pathology
- •Standing sedation eliminates risks and expense associated with general anesthesia for this procedure