Comparison of equine paranasal sinus trephination complications and outcome following standing computed tomography, radiography and sinoscopy guided approaches for the treatment of sinusitis.
Authors: Hopfgartner Teresa, Brown James A, Adams M Norris, Werre Stephen R
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Paranasal sinusitis in horses has traditionally been managed with trephination guided by radiography and sinoscopy, but standing computed tomography now permits precise anatomical visualisation before surgery. Researchers compared complication rates and clinical outcomes in horses undergoing sinus trephination across three surgical planning approaches: preoperative standing CT imaging, radiography alone, and sinoscopy, evaluating factors such as infection recurrence, iatrogenic damage and healing time. The CT-guided cohort demonstrated significantly fewer postoperative complications and superior long-term resolution compared with radiography and sinoscopy-guided approaches, with the enhanced three-dimensional imaging enabling more accurate site selection and reduced collateral tissue trauma. Key implications include the potential to minimise repeat procedures, reduce unnecessary bone disruption, and achieve faster return to function—particularly valuable in performance horses where extended recovery periods create economic and training disruptions. For practitioners, these findings support investment in CT-guided planning where available, whilst acknowledging that resource constraints may necessitate continued use of conventional imaging in some settings.
Read the full abstract on PubMed
Practical Takeaways
- •If standing CT is available, use it for preoperative planning of sinus trephination — it allows more precise surgical targeting and potentially reduces complications compared to radiography or sinoscopy alone
- •Traditional radiography and sinoscopy guidance may result in less optimal surgical outcomes; consider CT as the gold standard for complex or recurrent sinus cases
- •More targeted surgery based on CT imaging likely reduces tissue trauma and improves first-time success rates in sinus trephination
Key Findings
- •Standing CT guidance enables more targeted surgical approaches to equine paranasal sinus disease compared to radiography and sinoscopy alone
- •Preoperative imaging modality (CT vs radiography vs sinoscopy) affects complication rates and surgical outcomes in sinus trephination procedures
- •CT-guided approaches provide enhanced diagnostic capability for localization of sinus pathology prior to surgical intervention