Sinus flush/Bone flap surgery.....what to expect etc

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Patches

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I may be completely jumping the gun here as my horse isn't seen until this afternoon for scoping and x-rays to find out where her occasional nasal discharge is coming from. Indeed, she's been living out for a week now and I've not really seen anything from her nose in that time.

However, should they suggest a sinus flush, or a bone flap op to remove a cyst, for example, from the sinus can anyone tell me what to expect in terms of time off work, recouperation and aftercare etc?

I want to go into it all fully prepared. I know if they suggest an op I'll be that besides myself at the time that I won't ask enough questions.

If I have a rough idea of what to expect, I'll be more clued up on what to say when they vets are here this afternoon.
 
The majority of the time sinus surgery is done with the horse standing, under sedation, so you can be assured that it carries far less risks than a general anaesthetic. The extent of the wound and recuperation period depends on what is found. If it is thought to be an infectious process that requires flushing, then generally there will be one/two holes, around 1cm diameter. These should heal quickly, and provided the flushing is effective, then should not require to long a recuperation period.
Sinus cysts generally require a much larger hole - I have seen a maxillary sinus cyst removed through two large trephine holes, each around 8cm diameter, but slightly overlapping. This will obviously take much longer to heal. However, once the cyst has been removed, and the sinus has been given time to heal, then the convalesence period need not extend to full healing of the wound.
In either case, a gentle re-introduction to exercise is needed, over a fairly extended period (months), until the sinus and wound are fully healed. Heavy exercise will place greater stress on the sinus, due to air currents within it increasing with heavy exercise.
In my experience, the majority of persistent nasal discharges have a cause that can be treated medically. Good luck, and I hope this is the case for you!
 
Gee.....I wish I'd lived in ignorance.
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Thanks for the response though.

Scoping showed nothing abnormal at all and they felt it was probably just her being ultra sensitive as the discharge seems to only be in the lower nasal passage.

X-rayed her, while they were here, and they think they can see a cyst in the sinus. Definitely a suspicious looking "mass", most probably a cyst. Her x-rays are being sent to Leahurst to confirm their diagnosis and to organise the surgery to remove it.

I am gutted. I have only seen one horse that had bone flap surgery and the flap had obviously collapsed leaving a huge dent in it's face. I know it's shallow of me, but I'm worried P will suffer that sort of complication or they'll discover the "mass" is more sinister than a cyst.

It seems such a lot for her to go through when she appears so well in herself. Indeed, I've not seen any nasal discharge for a few days now that she's living out.

So much for hardy cobs! We've had tendon sheath flushing surgery, hock problems and now this.

She'll be pretty much un-insurable now. Poor P.
 
My friend's horse has been through this twice. Neither time did he need a huge amount of time off work and the vets actually advised her to get him back to work. Cosmetically, you can't really tell that he's had it done. If it turns out that your horse needs it feel free to ask me any questions and I'll pass them on. She actually stood in for the surgery both times and is now very knowledgable and knows what it's like to go through it.
 
my yearling had 2 sinus "C" flap ops last year he spent a week at the vets, 2 weeks box rest with trephine drain tube in being flushed twice a dayand then he went out with a fly mask on I used camrosa on his wound once the stitches were out her is a photo after the first op
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Thank you for sharing your story.

Poor little mite having two ops at such a young age. They do like to worry us, don't they?

What condition was your yearling diagnosed with? Patches has been initially diagnosed (waiting for Leahurst to confirm) with a bone cyst.
 
My now 12 year old had a bone flap, and two teeth removed as a 4yr old.

He does have a 'dent' in his face which is more obvious in the summertime, but it it just cosmetic, and suprisingly few people notice it!

He also had a flushing catheter for most on the time he was in hospital, and had another placed for 2 weeks (at home) a while later after another infection.

He was away from home for a week, but this was partly due to complications after the GA.

He does make a bit of an odd noise during fast work due to sinus reconstruction, but it has never effected him in any other way, and he has PN evented and done 2 3DE's.
 
Thanks for sharing another positive outcome with me. All I do is farm rides and their associated fences as well as schooling and hacking. Sounds like she should be able to cope with that, so long as it all goes smoothly.
 
My boy had 3 or maybe 4 sinus operations before I had him, both upper and lower sinuses. He didn't have any nasal discharge but i had him looked at by my vets at one point as he wasn't right ,and they took xays which showed a mass in his sinus. He went to Rossdales in Newmarket for yet another GA. He had a huge abscess removed and also a tooth which was cracked. They think the cracked tooth was probably the cause of all the original problems years ago and wondered why it hadn't been removed before. They just reopened his bone flap to do it. Afterwards he had staples in his face and a dressing. he had box rest for about a month I think although I did start to hand graze him towards the end.He then went out in a field by himself so hs face didn't getknocked while the bone was stll healing. He had to have daily antibiotic injections. He still wasn't right so went back to hospital to have a drain put in and swabs taken. It turns out the antibiotics he'd been given weren't the right ones. An anit-fungal wash for several days eventually sorted things out. He has been so much happier since then. he makes no noise during any work and does a bit of everything. He does have a dent in his face but has been shown with it. Some judges pick up on it and others don't appear to, although we don't do high level showing.

If your girl needs it done definitely get it done. i'm sure she will be happier for having it done. I liken my boy's problems to me hving sinusitis (which I have had several times) and you have a major headache all of the time. I have seen other horses have this sort f thing done. All of them bar one have been fine since. The other one has to have his sinus drained every so often.

When my boy was in hospital just to have the sinus drained they said he could still keep working even with the tubes inserted into his face. I'm not so sure the dog walkers I hacked past were too sure about me doing it tho!

I was advised to let him graze as much as possible and always feed from the floor as it would help keep the sinuses draining properly if there was anything in there.
 
My horse had a GA to remove a tooth via a bone flap following 2 unsuccessful trephines through both upper and lower sinuses. He looked like frankenstein when it was done, hundreds of staples and as he is black I was sure he would have a line of white hair. It healed brilliantly with only a couple of white hairs and wasnt dented at all. However over the next year or so it seemed to sink that much I was worried it would cave in! Wierdly it now looks normal, well if you srutinised him you would see a slight difference but nothing really at all.
Good luck, I hope everything goes well.
 
I really need to get a grip.

Right now it feels like it will be the end of the world if my horse ends up with a facial blemish after this procedure. I just can't get the fear of a whopping great hole in her face out of my head.

Being ugly myself, you'd think I'd be far more tolerant and definitely a whole lot less shallow.
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Am sorry to hear that P needs a sinus op.
WIll keep fingers crossed that she comes through with flying colours.

Don't forget the pics of Tia's horse who had the massive hole in its face. He healed up eventually didn't he with hardly a mark, and you know one of the only good things about owning a grey horse - they don't get horrid white scars.

Hugs

Fiona
 
patches, my yearling was diagnosed with a myxoma sinus tumour. Have faith in your vet surgery will look awful at first but it doesnt seem to affect horses she will want to eat
 
My horse has had sinus problems twice. Once aged 8 when he had trephination and finally sinus flap surgery on the right side. More recently, aged 25, he has had problems on the left side and has required two more trehpine holes and weeks of flushing.
Cosmetically, you would require a magnifying glass to figure out anything had happened on the right side. Scars are more or less invisible, and the flap was wired back into place, so it didn't go anywhere. The latest two holes are already next to invisible less than six months later.

Unfortunately, this latest round of sinusitis is still on-going and we have not yet been able to figure out the exact cause.

I'd say facial disfigurement should be the very least of your worries at this point. Fingers crossed your vets can get to the bottom of it and sort it for you.

I have plenty of interesting pictures if you want me to email you them...I'm not sure how to include them in a post.
 
Thank you PurpleDanny. Your horse's case sounds interesting and I do hope you manage to get to the bottom of his problems.

I've had an update from the vets at Leahurst.

Apparently, if I have understood correctly, she does NOT have a bone cyst in her sinus and the problem is actually a tooth! I think that's good news, I'm not sure!

She's got to go to Leahurst on the 27th of this month for standing stock surgery. They're unsure whether or not they will be removing the tooth at this point, but it's a possibility. She will be in overnight.

I am relieved that she's not booked down for a GA, at this time. I hope they can do it under sedation....whatever it is she's having done.

I asked my vet practice receptionist to double check with Leahurst that the diagnosis is tooth related and not sinus cyst and that was confirmed.

Now, I realise some teeth are still removed from above, meaning a bone flap procedure, but I am going to pray that P's tooth is less problematic.

I had actually calmed down with regards to the operation I thought she was going to have initially. As you say PD, I just wanted her fixing up.

Thanks for taking the time to reply.
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ahhhhhh well thats good!!!!

cause horses teeth constantly grow (herbivores wear their teeth down when they eat, so they have to continuously grow to allow them to..... well keep eating!:) ) it means that they might only remove part of the tooth, or even if its the whole tooth its not that big of a deal (I don't think).........

as you say its probably better than the sinus flushing and bone flap surgery etc under GA!
So YEY! (in a sense!)

Cuddles for P!
 
? I wouldn't say horses' teeth grow. Once they have their permanent teeth that is all they have. As they wear down over the years, they descend from the the space behind i.e. in the upper jaw, they come down from the sinus cavity. As the horse gets older, the sinus cavity gets larger as the teeth move down into the mouth as they are worn away over the years.

Also, re. the cyst. You might actually be in better shape if it is actually a cyst as they can often scrape it away and then flush the remnants after opening up the sinus with trephine holes. In my experience, they don't really know what is going on until they go in there. If it is a tooth, I've been told they need to go in through the sinus to knock it out. However, they can do a standing version of the operation with the obvious benefits this presents.
 
I think alot depends on which tooth it is, and I don't know which tooth is affected yet as I've not actually spoken to the vet at Leahurst.

I have known horses to have teeth removed through the mouth, but I've also heard of horses having them knocked out from above (in the sinus cavity as you state).

Knowing my luck, Patches will be the latter, and we still have the same level of surgery/aftercare/out of work issues that we'd have had with a bone cyst. I read alot of info which seems to suggest that cysts can offer reform after surgery, requiring more than one procedure. At least with a tooth...I'm hoping it can be solved in one operation (barring any infection into the sinus post op)

I'm not that lucky when it comes to horses and problems.
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[ QUOTE ]
Yes, you are absolutely correct; the cysts can come back.
Good luck with it!

[/ QUOTE ]

That's what worried me, hence why I was upset at the thoughtf of having to put her through surgery that I figured may need repeating more than once.

I do hope it's straightforward now, even if it needs extracting through the front of the sinus.
 
babooshkazx said:
Hi can you tell me the final outcome of p please im currently going through similar situation now with my mare😞
Click to expand...

We had a horse at work who has a cyst removed from his sinus. He had a small square scar left that was all. 3 years later another cyst appeared and he had the procedure repeated. Again with nothing more than a bit of a scar that wasn't that obvious. Sadly the horse was put down a couple of years later due to a totally unrelated problem (stood on a nail in the field that went in too deep and in the wrong place in the hoof 😥)
 
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