title: Paranasal sinus surgery through a frontonasal flap in sedated, standing horses.
abstract: OBJECTIVE
  To report experience with paranasal sinus surgery through a frontonasal flap in sedated, standing horses.
  
  
  METHODS
  Treatment of 10 horses with naturally occurring paranasal sinus disease through a frontonasal bone flap created with the horses standing.
  
  
  METHODS
  Ten adult horses.
  
  
  METHODS
  After restraint and sedation, local anesthetic was injected subcutaneously along the proposed incision line over the conchofrontal sinus and was instilled into the sinuses through a small hole created in the frontal bone. A 3-sided, rectangular, cutaneous incision that extended through the periosteum was created over the frontal and nasal bones. The incision was extended into the conchofrontal sinus using a bone saw, and the base of the flap, on the midline of the face, was fractured. The sinuses were explored, and the horse was treated for the disease encountered. The flap was repositioned; subcutaneous tissue and skin were sutured separately.
  
  
  RESULTS
  The horses had few signs of discomfort during creation of the bone flap and during disease treatment. Diseases encountered included inspissated exudate in the ventral conchal sinus (five horses), feed and exudate throughout the sinuses (one horse), occlusion of the nasomaxillary aperature (one horse), polyp (one horse), osteoma (one horse), and progressive ethmoidal hematoma (one horse).
  
  
  CONCLUSIONS
  In selected cases, surgery of the paranasal sinuses can be performed safely on sedated and standing horses through a frontonasal bone flap.
  
  
  CONCLUSIONS
  Performing surgery through a frontonasal bone flap with the horse standing and sedated, rather than anesthetized, eliminates risks and expense of general anesthesia.
authors.affiliation: Department of Large Animal Medicine and Surgery, Texas Veterinary Medical Center, College of Veterinary Medicine, College Station, USA.
authors.forename: J
authors.initials: J
authors.lastname: Schumacher
authors.forename: D M
authors.initials: DM
authors.lastname: Dutton
authors.forename: D J
authors.initials: DJ
authors.lastname: Murphy
authors.forename: B A
authors.initials: BA
authors.lastname: Hague
authors.forename: T S
authors.initials: TS
authors.lastname: Taylor
mesh_terms: D000698:Analgesia / Q000662:veterinary; D000701:Analgesics, Opioid; D000772:Anesthesia, Local / Q000662:veterinary; D000779:Anesthetics, Local; D000818:Animals; D002077:Butorphanol; D005260:Female; D005624:Frontal Bone / Q000601:surgery*; D015522:Frontal Sinusitis / Q000601:surgery / Q000662:veterinary*; D006734:Horse Diseases / Q000601:surgery*; D006736:Horses; D006993:Hypnotics and Sedatives; D007093:Imidazoles; D008012:Lidocaine; D008297:Male; D008619:Mepivacaine; D009295:Nasal Bone / Q000601:surgery*; D011182:Postoperative Care / Q000662:veterinary; D011187:Posture; D016896:Treatment Outcome; D014991:Xylazine
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D007093:Imidazoles; D014991:Xylazine; C041255:detomidine; D008012:Lidocaine; D008619:Mepivacaine; D002077:Butorphanol