Case Report

A bilateral sinus cyst treated via a bilateral frontonasal bone flap in a standing horse

Mickaël P. Robert, Gideon P. Stemmet, Yolandi Smit
Journal of the South African Veterinary Association | Vol 90 | a1729 | DOI: https://doi.org/10.4102/jsava.v90i0.1729 | © 2019 Mickaël P. Robert, Gideon P. Stemmet, Yolandi Smit | This work is licensed under CC Attribution 4.0
Submitted: 27 August 2018 | Published: 28 March 2019

About the author(s)

Mickaël P. Robert, Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa
Gideon P. Stemmet, Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa
Yolandi Smit, Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa


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Abstract

Bilateral paranasal sinus diseases are rarely reported in horses. Treatment using a bilateral frontonasal bone flap on a standing, regular-sized adult horse has not been described previously. A 13-year-old Thoroughbred gelding was evaluated for bilateral mucopurulent nasal discharge. Radiographic, endoscopic and computed tomographic examinations revealed bilateral sinus pathological changes consistent with an ethmoid haematoma involving the maxillary and frontal sinuses. A bilateral frontonasal bone flap was created under standing sedation and local anaesthesia. A tracheotomy was performed initially to ensure a patent airway during the procedure. Additional analgesia had to be given to transect the dorsal part of the nasal septum while elevating the flap. The sinus masses were removed and communications with the nasal cavities created uneventfully. Small sequestra were removed transendoscopically from the left caudal maxillary sinus 4 weeks after the initial procedure. The horse made a complete recovery with an excellent cosmetic outcome. Histopathology revealed the mass to be a sinus cyst. We concluded that a bilateral sinus bone flap can be used in adult regular-sized horses to access the left and right paranasal sinuses simultaneously. Regional nerve blocks should be performed in order to increase analgesia. A temporary tracheotomy prevents any airway obstruction during the procedure. The post-operative cosmesis is excellent.

Keywords

frontonasal bone flap; sinus cyst; standing surgery; horse

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