Evaluation of a novel post operative treatment for sinonasal disease in the horse (1996-2007).
Authors: Hart S K, Sullins K E
Journal: Equine veterinary journal
Summary
# Editorial Summary: Post-operative Management of Equine Sinonasal Disease Between 1996 and 2007, Hart and Sullins retrospectively analysed 91 horses undergoing surgical treatment for sinonasal disease using a specific post-operative protocol involving standing re-opening of sinus flaps. The key innovation was planned flap reopening under standing sedation at a median of 3 days post-operatively, allowing reassessment and further debridement or lavage in 43% of cases, with 97% of horses surviving to discharge and incision infection representing the most common complication at 29%. Recurrence rates varied significantly by pathology: paranasal sinus cysts showed the lowest recurrence at 5%, progressive ethmoid haematomas at 12%, and neoplasia at 50%—substantially lower figures than previously reported for these conditions. By avoiding prolonged general anaesthesia and allowing staged, controlled evaluation of the surgical site, this approach appears to reduce operative time, intraoperative haemorrhage, and long-term complications whilst maintaining excellent short-term survival. For practitioners managing horses with chronic or recurrent sinus disease, this protocol offers evidence that planned standing flap re-opening optimises the chances of successful resolution, particularly for cystic and haematomatous lesions.
Read the full abstract on PubMed
Practical Takeaways
- •Standing re-opening of sinus flaps at 3 days post-op allows controlled assessment and treatment in a safer environment than under general anaesthesia
- •This post-operative protocol achieves excellent short-term survival (97%) and low recurrence rates for cysts (5%) and haematomas (12%), making it valuable for equine surgical practitioners
- •Plan for approximately 43% of surgical cases to require additional debridement/lavage; incision infection management should be anticipated as the most common complication
Key Findings
- •97% of 91 horses survived to discharge following surgical treatment with the novel post-operative protocol
- •43% of horses required further debridement and/or lavage when sinus flaps were re-opened standing at median 3 days post-operatively
- •Recurrence rates were 5% for paranasal sinus cysts, 12% for progressive ethmoid haematoma, and 50% for neoplasia
- •Incision infection was the most common complication at 29%, with no horses requiring blood transfusion