Paranasal sinus surgery

• Upper airway endoscopy: this is the first diagnostic step. It allows us to confirm that the discharge is coming from the sinuses and not from another region of the airway system.
• Dental examination: sinusitis can be secondary to a dental infection which is why it is of paramount importance to perform a proper dental examination. However, some dental problems cannot be identified during routine dental examination.
• Radiography: head radiographs often detect the presence of sinus disease. Unfortunately, they don’t always allow us to precisely identify certain lesions, which is crucial to obtain an accurate diagnosis and for surgical planning.
• Sinoscopy: used to both diagnose and treat certain sinusal diseases. It consists in making a small hole in the horse skull so we can insert an endoscope and directly visualize the different sinuses. During the procedure, treatment can be implemented (sinus lavage, small tumour or cyst removal).
• Mini-sinoscopy: this technique is based on traditional sinoscopy but uses a less invasive approach and a mini-camera, and allows a quick visualization of the inside of the sinuses. This technique has been recently developed by our surgical team.
• CT-Scan: with the CT, we can obtain high-quality images of the entire head of the horse. It has the best diagnostic rate for sinusal and dental diseases. However, for the moment it requires general anesthesia to be performed.

Sinusal affections are extremely complex which is why the association of the different techniques previously described is usually required to obtain a precise diagnosis and treat your horse.

The complex sinus anatomy and the difficulty to obtain an accurate diagnosis, make sinus surgery susceptible to several complications. The main ones are: surgical wound infection, formation of bone sequestrum or a fistula and recurrence or incomplete resolution of the disease (approximately 25% of cases). If the sinusitis was secondary to a dental infection, the complication rate can be higher with a risk of chronic sinusitis development.

It is important to monitor the wound carefully and monitor your horse for the reappearance of nasal discharge or facial swelling after any sinus surgery.

If a tooth was removed, make sure your horse has a good appetite and eats properly.

If a tooth was removed, dental examinations will have to be performed more frequently in the future to monitor the growth of the opposite tooth.