When radiography and nasal endoscopy are inconclusive as to the aetiopathogenesis of sinusitis, sinoscopy is the next likely investigative procedure [1]. It is well tolerated in standing sedated horses [2]. It has been shown to provide useful diagnostic information in 67-100% of cases [3-5]. Currently, the optimum route for fenestration of the ventral conchal bulla (VCB) is under sinoscopic guidance through the conchofrontal sinus (CFS), permitting adequate observation of the rostral maxillary sinus(RMS) and ventral conchal sinus (VCS) in 88-95% of cases [3,6]. The technique and equipment required are well described by 0' Leary and Dixon [7]. It is important to investigate the 2 rostral sinus compartments (RMS and VCS) as they were found to be involved in 61% and 54% in one study [3],Sinus trephination is indicated for sinoscopy, placement of a lavage tube, endoscopic fenestration of the VCB, sinoscopically guided sinus surgery (mass biopsy, removal of inspissated pus, conchal bone sequestrate, small sinus cyst, fungal plaques, formalin injection) or removal of small intrasinus progressive ethmoid haematomas.
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