Validation of a 2-mm videoendoscope for the evaluation of the paranasal sinuses with a minimally invasive technique.
Authors: Pouyet Morgane, G Bonilla Alvaro
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Pouyet and Bonilla (2020) developed and validated a minimally invasive sinoscopy technique using a 2-mm flexible videoendoscope as an alternative to traditional surgical approaches for paranasal sinus evaluation in horses. The research progressed through three phases: initial cadaveric work to establish anatomical landmarks and needle portal placement (15 skulls total), a validation phase comparing endoscopic visualisation against direct surgical exploration via frontal and maxillary bone flaps (10 cadavers), and finally clinical application in six healthy sedated horses. Using only frontal and rostral maxillary portals created with a 14-gauge needle, the team achieved thorough exploration of the majority of sinus compartments whilst maintaining patient tolerance with no significant complications reported. For practitioners, this technique represents a genuine shift in diagnostic capability—offering enhanced visualisation compared to traditional radiography whilst eliminating the recovery costs and complications associated with invasive surgical flaps, though successful implementation requires both specialised equipment and formal training in the endoscopic approach.
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Practical Takeaways
- •Minimally invasive sinoscopy provides a diagnostic alternative to traditional surgical sinus exploration, reducing tissue trauma and recovery time for horses with suspected sinus disease.
- •Specific anatomical landmarks and portal placement are critical—frontal and rostral maxillary approaches allow comprehensive sinus evaluation without extensive bone removal.
- •Practitioners considering this technique need specialized 2-mm endoscope equipment and specific training; it is well-tolerated under standing sedation in cooperative horses.
Key Findings
- •A 2-mm flexible endoscope can be successfully used for minimally invasive sinoscopy through 14-gauge needle portals in the frontal and rostral maxillary regions.
- •Endoscopic findings were confirmed by direct visualization via bone flaps in cadaveric specimens, validating the diagnostic accuracy of the technique.
- •The procedure was well tolerated in standing sedated horses with no relevant complications reported.
- •Thorough evaluation of most sinus structures was achievable using only frontal and rostral maxillary portals, avoiding more invasive surgical approaches.