Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Tech, VA, USA.
Equine Vet J. 2011 Jan;43(1):24-9. doi: 10.1111/j.2042-3306.2010.00133.x.
Results of surgical treatment of sinonasal disease in horses have been reported previously; however, this paper describes the outcome of horses in which a specific post operative treatment protocol was used.
The objectives of the study were to determine: 1) short- and long-term outcome; 2) complications; and 3) recurrence rates of different disease processes, when horses were treated with a specific treatment protocol.
Medical records of horses presented for surgical treatment of sinonasal disease from 1996-2007 were reviewed. Results and duration of surgical exploration were recorded. Post operatively, the sinus flaps were re-opened with the horses standing and sedated. Number of horses requiring further treatment (debridement and/or lavage), median number of post operative days when the flap was re-opened, median number of times the flap was opened and median duration of hospitalisation were recorded. Short- and long-term survival and complication rates were determined.
Ninety-one horses were included in the study. The sinus flaps were re-opened with the horses standing a median of 3 days post operatively. Thirty-nine horses (43%) required further treatment at this time and 89 horses (97%) survived to discharge. Incision infection was the most common complication encountered (29%). No horse required a blood transfusion. Recurrence rates were 5% for paranasal sinus cysts, 12% for progressive ethmoid haematoma and 50% for neoplasia.
Rapid removal of the primary lesion followed by packing the sinuses and re-evaluating in the standing horse in a more controlled environment offers a safe and effective means to thoroughly assess and treat sinonasal disease.
Surgical time, intraoperative haemorrhage, long-term complications and recurrence rates of paranasal sinus diseases treated via frontonasal or maxillary sinus flap may be reduced using this technique.
此前已经报道过马的鼻旁窦疾病的手术治疗结果；然而，本文描述了使用特定术后治疗方案的马的结果。
本研究的目的是确定：1）短期和长期结果；2）并发症；以及 3）不同疾病过程的复发率，当使用特定治疗方案治疗马时。
回顾了 1996-2007 年因鼻旁窦疾病接受手术治疗的马的病历。记录了手术探查的结果和持续时间。术后，在马站立和镇静的情况下重新打开窦瓣。需要进一步治疗（清创和/或冲洗）的马的数量、重新打开瓣的术后天数中位数、瓣打开的次数中位数和住院时间中位数均记录在内。确定短期和长期存活率和并发症发生率。
本研究纳入了 91 匹马。窦瓣在术后第 3 天中位数重新打开。此时，39 匹马（43%）需要进一步治疗，89 匹马（97%）存活至出院。最常见的并发症是切口感染（29%）。没有马需要输血。复发病例率为副鼻窦囊肿 5%、进行性筛窦血肿 12%和肿瘤 50%。
快速切除原发性病变，然后在更受控的环境中用填塞物填充窦腔并在站立的马身上重新评估，为彻底评估和治疗鼻旁窦疾病提供了一种安全有效的方法。
通过额窦或上颌窦瓣治疗副鼻窦疾病，可以减少手术时间、术中出血、长期并发症和复发率。
