Alleviation of Epiphora by Canaliculosinostomy into the Caudal Maxillary Sinus in the Horse.
Authors: Robinson Claire S, Wylie Claire E, Compston Polly C, Payne Richard J
Journal: Veterinary surgery : VS
Summary
# Chronic epiphora in horses frequently results from nasolacrimal duct obstruction, which can be challenging to manage medically and impacts both welfare and appearance. Robinson and colleagues described a surgical technique involving canaliculosinostomy—creating a direct communication between the lacrimal canaliculus and the caudal maxillary sinus—to bypass the obstructed duct, performed on five horses using a Steinmann pin to create the stoma and a Foley catheter (left in situ for three weeks) to maintain patency during initial healing. All five horses experienced uncomplicated surgery, with four demonstrating complete resolution of epiphora at long-term follow-up ranging from 24–46 months postoperatively; one horse was euthanised for unrelated reasons at ten weeks when epiphora had already resolved. This straightforward technique offers veterinary surgeons a definitive surgical solution for chronic epiphora secondary to nasolacrimal duct obstruction, with excellent long-term outcomes and minimal morbidity—particularly valuable for cases that have failed conservative management or where the obstruction is irreversible. The versatility of the approach across different aetiologies of obstruction makes it a practical addition to the surgical toolkit for managing this frustrating condition in equine practice.
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Practical Takeaways
- •This canaliculosinostomy technique offers a straightforward surgical option for horses with chronic epiphora due to nasolacrimal duct obstruction, with excellent long-term outcomes (80% resolution sustained 2+ years).
- •The procedure requires minimal specialized equipment (Steinmann pin, Jacob's chuck, Foley catheter) and can be performed under general anesthesia with a 3-week post-operative catheter management period.
- •Consider this technique for horses with epiphora refractory to other treatments, though this small case series suggests further evidence would support clinical decision-making.
Key Findings
- •Canaliculosinostomy into the caudal maxillary sinus successfully resolved epiphora in 4 of 5 horses (80% success rate).
- •Long-term follow-up of 24-46 months showed sustained resolution of epiphora with no postoperative complications except one catheter dislodgement at 3 days.
- •The surgical technique using a Steinmann pin and Foley catheter placement is simple to perform with no intraoperative complications reported.