Headshaking in 5 horses after paranasal sinus surgery.
Authors: Gilsenan William F, Getman Liberty M, Parente Eric J, Johnson Amy L
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Paranasal sinus surgery in horses carries a previously underreported risk: post-operative headshaking attributable to presumptive trigeminal neuritis, a condition affecting the trigeminal nerve responsible for facial sensation. This retrospective case series examined five horses that developed headshaking within 45 days of sinus surgery between 2007 and 2010, tracking clinical outcomes and responses to treatment. Only two of the five horses fully resolved their symptoms with intervention, whilst one was euthanised due to uncontrollable clinical signs; the remaining pair experienced persistent headshaking, though in one case this was sufficiently managed with analgesia. Most concerning from a performance perspective, only two of five horses ultimately returned to full work, suggesting that trigeminal neuritis following sinus surgery represents a potentially career-limiting or fatal complication that veterinary surgeons should discuss with owners prior to procedures. Given the severity of outcomes and the relatively narrow window for early recognition (within 45 days post-operatively), heightened awareness amongst equine practitioners and owners is warranted, particularly regarding pain management strategies and realistic prognostic counselling for affected animals.
Read the full abstract on PubMed
Practical Takeaways
- •Inform clients that headshaking is a recognized post-operative complication of sinus surgery occurring within 45 days; prognosis for return to work is guarded (40% success rate in this series)
- •If headshaking develops after sinus surgery, pursue diagnostic investigation for trigeminal neuritis and consider conservative management with analgesics before assuming the horse cannot return to work
- •Ensure informed consent discussions pre-operatively include headshaking as a potential serious complication that may prove career-limiting or fatal despite treatment attempts
Key Findings
- •5 horses developed headshaking within 45 days of paranasal sinus surgery, presumed to be trigeminal neuritis
- •Only 2 of 5 horses (40%) returned to full work after developing headshaking
- •Resolution occurred in 2 horses with treatment; 1 horse was euthanatized; 2 horses had persistent headshaking managed with analgesics or observation
- •Headshaking secondary to trigeminal neuritis represents a potential career-ending or fatal complication of paranasal sinus surgery