Standing excision of the nasal septum of 12 horses.
Authors: Brink Palle, Schumacher James, Ducharme Norm G, Caniglia Christopher J, Caruso Michael A, Ortved Kyla
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Standing Nasal Septum Excision in Horses Septal disease in horses can significantly compromise airway function, yet traditional surgical correction requires general anaesthesia with its associated expense and risks. This retrospective review examined 12 horses undergoing standing excision of the nasal septum using a combination of sedation, topical desensitisation, infiltration anaesthesia, and regional nerve blocks—with six animals also requiring laryngotomy to position obstetrical wire for precise septal incision placement. All 12 horses had their septa resected successfully, with surgeons noting subjectively less intraoperative haemorrhage than typically observed during recumbent procedures; eleven horses returned to their original work, though one animal died, likely from complications related to maxillary nerve blockade. For practitioners managing horses with septal deviation, haematoma, or other obstructive lesions, this standing technique offers a compelling alternative that eliminates general anaesthesia risks whilst maintaining surgical efficacy, though the single mortality emphasises the importance of careful maxillary nerve block administration and close perioperative monitoring. The approach warrants consideration as a cost-effective option for suitable candidates, particularly those presenting anaesthetic risks or where client finances constrain access to general anaesthesia.
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Practical Takeaways
- •Standing nasal septum excision is a viable alternative to recumbent surgery, potentially reducing anesthetic complications and associated costs for your clients
- •Careful nerve block technique and monitoring is essential—one mortality in this series was attributed to maxillary nerve block, so proper anatomical knowledge and precautions are critical
- •The standing approach may reduce intraoperative hemorrhage, which could improve surgical visibility and reduce operative time compared to traditional recumbent technique
Key Findings
- •Nasal septum excision can be performed safely in standing horses using sedation combined with topical, local, and regional anesthesia
- •Standing procedure resulted in subjectively less hemorrhage compared to recumbent approach
- •11 of 12 horses (92%) returned to original intended use; 1 horse died, presumably from maxillary nerve block complication
- •Technique eliminates risks and expenses associated with general anesthesia in horses with nasal septum disease