Comparison of Sinoscopic Techniques for Examining the Rostral Maxillary and Ventral Conchal Sinuses of Horses

Authors

  • JUSTIN D. PERKINS BVetMed, MS, Cert ES (Soft Tissue), Diplomate ECVS,

    1. Department of Veterinary Clinical Sciences, Royal Veterinary College, North Mymms, Hertfordshire, UK
    2. Army Medical Directorate, Former Army Staff College, Camberley, UK
    3. Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN.
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  • CEES BENNETT BVetMed,

    1. Department of Veterinary Clinical Sciences, Royal Veterinary College, North Mymms, Hertfordshire, UK
    2. Army Medical Directorate, Former Army Staff College, Camberley, UK
    3. Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN.
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  • ZOË WINDLEY BVetMed Hons,

    1. Department of Veterinary Clinical Sciences, Royal Veterinary College, North Mymms, Hertfordshire, UK
    2. Army Medical Directorate, Former Army Staff College, Camberley, UK
    3. Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN.
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  • JIM SCHUMACHER DVM, MS, Diplomate ACVS

    1. Department of Veterinary Clinical Sciences, Royal Veterinary College, North Mymms, Hertfordshire, UK
    2. Army Medical Directorate, Former Army Staff College, Camberley, UK
    3. Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN.
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Address reprint requests to Justin D. Perkins, BVetMed, MS, Cert ES (Soft Tissue), Diplomate ECVS, Department of Veterinary Clinical Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK. E-mail: jperkins@rvc.ac.uk

Abstract

Objective— To develop a reliable technique for sinoscopic examination of the ventral conchal (VCS) and rostral maxillary sinuses (RMS) of horses

Study Design— Descriptive study

Animals— Cadaveric equine heads (n=40)

Methods— The VCS and RMS were examined endoscopically using: (1) rostral trephination of the RMS (rostral RMS approach); (2) caudal trephination of the RMS (caudal RMS approach); (3) conchofrontal sinus (CFS) trephination followed by RMS trephination at a site identified by endoscopic transillumination of the maxillary bone at the most rostral aspect of the caudal maxillary sinus (CMS) (light-indicated RMS approach); (4) CFS trephination with fenestration of the ventral conchal bulla (VCB; frontal VCB approach); (5) CMS trephination with VCB fenestration (caudal VCB approach); and (6) CFS and CMS trephination with VCB fenestration (combined VCB approach).

Results— Success in observing the rostral and caudal aspects of the VCS and RMS with each approach were: (1) rostral RMS approach (0 horses; 16 horses [40%]); (2) caudal RMS approach (0 horses; 11 horses [28%]); (3) light-indicated RMS approach (3 horses [8%]; 24 horses [60%]); (4) frontal VCB approach (24 horses [60%]; 29 horses [73%] respectively); (5) caudal VCB approach (16 horses [40%] both structures); and (6) combined VCB approach (27 horses [68%]; 35 horses [88%]).

Conclusions— Trephination into the CFS coupled with fenestration of the VCB provided consistent access to both the rostral and caudal aspects of the RMS and VCS. A trephine hole into the RMS provided poor access to the VCS, and placed the reserve crowns of the maxillary cheek teeth at risk of damage.

Clinical Relevance— The RMS and VCS can be best examined endoscopically using approaches with fenestration of the VCB.

Ancillary