Conchofrontal flap surgical technique for the resolution of sinuses pathologies in the horse

Abstract

The paranasal sinuses of horses are identified as large air-filled spaces that are inaccessible by most diagnostic methods, making them difficult to diagnose and treat when abnormalities occur. Sinus pathologies are considered common in horses, and this is mainly due to their location, as they are susceptible to the spread of infections through the nasal cavity and tooth roots, especially the cheek teeth, leading to primary and/or secondary sinusitis. Cases of primary sinusitis can usually be easily resolved by nasal irrigation and systemic antibiotic therapy. However, in cases of secondary sinusitis and therefore due to underlying causes, the clinical picture becomes more complicated, not only because of the cause of the disease itself, which can be variable: sinus cyst, ethmoidal hematoma, neoplasms, etc., but also because when clinical signs appear, the diseases are usually in an advanced stage. For this reason, in cases of sinusitis due to underlying causes, surgical techniques such as the conchofrontal flap are preferred, because, despite its invasiveness, it allows a good visualization and facilitates the manipulation of structures present in the sinuses, facilitating their treatment. Although there are several surgical techniques for the resolution of these pathologies, over the years it has been shown that the flap technique is more indicated since, in addition to the advantages mentioned above, it serves both as a diagnostic technique and as a treatment and allows the surgery to be performed with the animal standing and sedated, favoring not only a lower incidence of the typical complications of this type of intervention, such as profuse bleeding, but also a faster recovery and postoperative period and a lower incidence of postsurgical problems like recurrences. Thanks to this, animals subjected to this surgical procedure are able to recover their sporting performance.