Treatment of Equine Sinusitis

Surgical treatment of sinusitis is often performed in the standing horse (lower cost, no anaesthesia risk; and less intra-operative haemorrhage - due to the higher position of the horse’s head). A common surgical approach in non-responsive chronic sinusitis cases is the use a large naso-frontal flap that is hinged medially in the standing or anaesthetised horse. This approach allows good access to the caudal maxillary sinus and thus to the ventral conchal bulla (caudo-dorsal aspect of the ventral conchal sinus), that can be opened (with minimal haemorrhage usually) and the adjacent rostral maxillary also explored, by resecting the maxillary septum if necessary. A search is made for inspissated pus which is removed if present. In older horses that have shorter reserve crowns and thus better access to the ventral conchal sinus, a maxillary sinusotomy can be performed (Fig 1) and indeed this approach (with a smaller osteotomy site) can be used with care in most horses. […]