A single caudally based frontonasal bone flap for treatment of bilateral mucocele in the paranasal sinuses of an American miniature horse.
Authors: Easley Jeremiah T, Freeman David E
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Bilateral mucoceles of the paranasal sinuses are uncommon but clinically significant lesions that typically require separate surgical approaches for each side; this case report documents a novel technique using a single caudally based frontonasal bone flap to address both sinuses simultaneously in a standing procedure. A 6-year-old castrated American Miniature Horse presenting with bilateral mucocele affecting the conchofrontal sinuses underwent surgery to remove accumulated mucous material and establish permanent drainage pathways into the nasal cavities through the single flap approach. The procedure achieved complete resolution of clinical signs, including nasal discharge and breathing difficulties, whilst providing excellent visualisation of both right and left paranasal sinuses. For equine practitioners, this technique represents a significant refinement in surgical management of bilateral sinonasal disease, potentially reducing operative time, anaesthetic exposure and tissue trauma compared with bilateral separate approaches—particularly valuable in miniature horses and ponies where anatomical constraints create technical challenges. Whilst based on a single case, the success demonstrated here suggests the technique warrants further evaluation as a viable standing procedure for bilateral paranasal sinus conditions in the equine population.
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Practical Takeaways
- •This single bone flap technique offers an efficient surgical option for treating bilateral paranasal sinus disease in horses, potentially reducing operative time and tissue trauma compared to separate approaches
- •The procedure can be performed in standing sedation, which may reduce anesthetic risk in compromised patients
- •Consider referral for this technique if managing bilateral sinus mucoceles refractory to conservative treatment
Key Findings
- •A single bilateral frontonasal bone flap successfully provided simultaneous access to both right and left conchofrontal sinuses in a standing procedure
- •The procedure completely resolved nasal discharge and breathing difficulty in this miniature horse
- •The novel surgical approach allowed excellent visualization and drainage establishment into both nasal cavities