A long-term study of sinoscopic treatment of equine paranasal sinus disease: 155 cases (2012-2019).

Authors: Dixon Padraic M, Kennedy Rebekah, Poll Kirsty, Barakzai Safia, Reardon Richard J M

Journal: Equine veterinary journal

DOI: 10.1111/evj.13393 PubMed: 33222250Log in to save

Summary

# Editorial Summary: Long-term outcomes of standing sinoscopic sinus treatment in horses Between 2012 and 2019, researchers at the University of Edinburgh retrospectively reviewed 155 cases of equine paranasal sinus disease treated via standing sinoscopy, with follow-up data obtained from clinical records and owner questionnaires to assess long-term success rates and complications. Whilst 69.7% of horses responded fully to initial sinoscopic treatment, the study's most striking finding was that 96.1% ultimately achieved complete resolution after additional interventions where necessary, with only 2.6% requiring the more invasive sinonasal fenestration procedure. Key reasons for initial treatment failure included retained intra-sinus bone sequestra (5.8%), inspissated exudate (3.9%), concurrent intranasal lesions such as infected conchal bullae (4.5%), and misdiagnosed dental apical infections (2.6%)—factors that highlight the importance of thorough endoscopic exploration and complete removal of debris during the primary procedure. Portal wound infection occurred in fewer than 6% of cases, confirming that sinoscopy remains a genuinely minimally-invasive approach with low morbidity, though practitioners should be alert to the substantial proportion of cases harbouring secondary pathology within the nasal cavity itself. For farriers and equine practitioners referring cases for sinus surgery, these data support sinoscopic treatment as a first-line approach, whilst emphasising to veterinary surgeons the critical importance of meticulous intra-operative cleaning and careful assessment of concurrent intranasal disease to maximise first-treatment success.

Read the full abstract on PubMed

Practical Takeaways

•Sinoscopic treatment achieves long-term success in over 96% of sinus disease cases with minimal morbidity, making it the preferred first-line approach for most equine sinus disorders
•Ensure thorough removal of bone sequestrae and inspissated exudate during sinoscopic procedures, as incomplete clearance is a major cause of treatment failure requiring repeat intervention
•When initial sinoscopic treatment fails, further sinoscopic treatment as an outpatient procedure succeeds in 79% of cases (34/43), avoiding the need for invasive sinusotomy or fenestration

Key Findings

•69.7% of horses (108/155) fully responded to initial sinoscopic treatment
•96.1% of all cases (149/155) showed full improvement with long-term follow-up, including those requiring repeat or additional treatment
•Common causes of treatment failure included intra-sinus bone sequestra (9 cases), inspissated exudate (6 cases), and infected conchal bullae (7 cases)
•Only 2.6% of cases (4/155) required sinonasal fenestration, demonstrating sinoscopy as a minimally-invasive alternative to open surgery

Conditions Studied

paranasal sinus diseaseethmoid haematomasino-nasal disordersdental apical infectionsoro-maxillary fistulaeintranasal lesions

Related References

Equine paranasal sinus disease: a long-term study of 200 cases (1997-2009): treatments and long-term results of treatments.

Dixon P M, Parkin T D, Collins N, Hawkes C, Townsend N, Tremaine W H, Fisher G, Ealey R, Barakzai S Z(2012)Equine veterinary journal

Evaluation of a novel post operative treatment for sinonasal disease in the horse (1996-2007).

Hart S K, Sullins K E(2011)Equine veterinary journal

Equine paranasal sinus disease: a long-term study of 200 cases (1997-2009): ancillary diagnostic findings and involvement of the various sinus compartments.