Mise au point d’une technique de sinusoscopie peu invasive chez le cheval
Paranasal sinus disease is the most common cause of unilateral nasal discharge in horses. However, achieving a definitive diagnosis using radiology and endoscopy is difficult due to the complex anatomy of the sinuses, and the use of computed tomography (gold standard) is often limited due to its cost and low availability. Consequently, sinoscopy is often the available diagnostic technique with the highest diagnostic rate (70%) but it remains invasive (10 to 15 mm trepanation) and unpractical in some cases. Our hypothesis is that the development of a minimally invasive sinoscopic technique (MIST), performed through a mini-trepanation with a 14G needle (2 mm trephination) and combined with the use of a novel flexible 2mm diameter endoscope, can allow an exhaustive evaluation of the paranasal sinuses.   During the first two cadaveric phases of the project, we determined the exact anatomic landmarks to perform the mini-trepanation in the different sinuses, and the visualization of the different sinus compartments was assessed by attributing a score to each sinusal structure. In the last phase of the study, the MIST was performed on standing sedated horses to determine the feasibility and possible complications associated to the technique.  The landmarks determined in the first phase allowed a thorough evaluation of the sinuses in the following phases. The horses tolerated well the procedure and no serious complications were reported. The technique developed during this study is easy to perform and could facilitate the diagnosis of paranasal sinus diseases for all veterinarians specialized or not.
sinus horse equine sinoscopy Minimally invasive surgery