[teal tea]

Hi I was wondering if anyone has ever had this procedure done and what the cost was? My mare began having a runny nose and a bad smell from her nose. X rays revealed a mass that could have been a tumor, tooth problem or material that was not draining well and would have to be removed. We sent off a biopsy to rule out cancer and it came back negative. After several weeks of antibiotics my horse continued w/ the drainage.

Sinus flap surgery has always been a possibility. My trainer took her back to the vet today and I just found out right now after they closed. The vet said it was hard to estimate the cost of surgery but it could be $2500. There is a possibility it's a tooth so that would add to the cost of the surgery (it's hard to tell if it is a tooth b/b of all the gunk in her nose. Of course dumb me did not insure the horse so I am going to pay out of pocket. I have to make arrangements for the cost and I would appreciate a rough estimate from anyone who has gone through this. I'll find out for sure tomorrow about the cost, but if anyone can give me an idea tonight, I would appreciate it.

[Halt Near X]

PMing you momentarily.

[spacytracy]

Can you explain sinus flap? It might be the same as what I had done for my mare. She had sinusitis, did not resolve, they sedated her, drilled a hole in her face, flushed out all the guck, and then for a month after, I had to keep the hole open, flush it with betadine solution, and give her twice daily injections, along with SMZs.

She healed 100% and never had a recurrence. It ran me around 2k about 6 years ago.

[Halt Near X]

The hole drilling is trephination.

The sinus flap is when they cut a C (usually) shaped incision in the sinus bone so they can actually open it up, get in there, and see what's going on and then do whatever they need to do to resolve it.

[BeastieSlave]

Mr Studly had an L shape sinus flap. I think the surgery was around $1,500 at the vet school 3? years ago. He had a tumor, and it did grow back - it' s a hard place to 'clean out'. He did well with the surgery & he was 20 at the time

[2tempe]

My prior mare had this done about 10 years ago at Ohio State. It ran me $1500 then +/- a few $. She was an almost white gray, so it looked pretty frightening when I brought her home, but the process went well, and no more drippy nose. I think they kept her three days to be sure all was well. Prior to surgery, we spent a bunch of time and antibiotics trying to clear up her problem; I don't remember a bad smell and no teeth were involved. My non-doctor description of the process is that they roto-rooted her sinus canal...

[Auburn]

2tempe,

Did Dr. Robertson do the surgery?

My OTTB mare had the same surgery at Ohio State. She did not do well. We could not get the flap area free from infection. She was 15 years old. Two weeks after the surgery, she died from a Procane Penn. injection.

I believe that the surgery cost was about the same for me, as yours was. However, the aftercare, return trip to OSU and meds after that cost over $2,000.

I had mortality insurance, which helped with the cost of losing her.

[Karosel]

Fall of 2011 I paid about $3200 CAD for this surgery plus another grand or so for antibiotics. A tooth was removed as well. A month of twice a day flushing of her sinuses and lots of antibiotics for 2 months after still didn't resolve the issue. The vet said he could do another extensive surgery + MRI before hand (2k plus for the MRI, and 4-5K for the second surgery). And even then the vet was doubtful the procedure would even work. So I had my mare euthanized instead. I paid out of pocket for this. My current horse is insured.

[2tempe]

AUBURN - Dr Beard did my mare's surgery. So sorry to hear about your mare.

[teal tea]

Thanks for everyone's input. The vet said the cost would be around $1500 (hopefully w/ no added costs for complications). They took another X-ray and determined that it was a tooth issue. Actually there are 2 teeth involved. We had already had the nasal area lavashed (sp?) but none of the chunky mucous filled pus came out. So Monday, my mare will have the flap surgery to remove the gunk in her nose and to have the teeth pulled.

I'm sorry for the owners who have had bad experiences. . Hopefully my mare will fare better. I'm also aware, having read some other threads on tooth/sinus issues, and having been warned by my vet, that these problems sometimes are difficult to be fully resolved.

[ToTheNines]

Good luck! Mine had the same thing, two back upper molars. My dentist/vet did not want to extract both at once, so he took his best opinion which to extract. I was really worried about tooth issues after reading some horror stories. But the tooth came out all in one piece with the extraction where they loosen the ligaments and wiggle it out. No complications, and so far (almost a year later) the other tooth has not seemed to bother him. Whew!

[Martha Drum]

I have a mare who had the sinus flap surgery, a three-edges-of-a-rectangle-shaped incision below her eye in 1999. She had an abscessed molar tooth removed; they discovered in surgery (at Tufts) that she actually had a full size, fully erupted EXTRA molar tooth on both sides of her upper jaw. The surgeon said he had never seen that before. I was warned that this can recur, especially due to her unusual dentition, and it did -- about a year later, the snots and smell came back, and she went back to surgery and they removed 2 more teeth. After that, the problem did not return so severely; in the past 13 years, she's had about 3-4 sinus infections, and they resolved quickly with oral SMZs.

Cost was about $2500 each time; insurance paid the first time, but not the second. There was also the cost for SMZs and the effort of flushing the surgical site for a while afterwards, as other posters mentioned. It was disturbing to see her immediately after surgery, with much of her face clipped and swelling around the staples closing the incision site, but that passed with time. She has a scar (remember, she had two surgeries through the same incision), but it is only visible in her summer coat.

So she has 7 cheek teeth on her upper right side, and now, after both surgeries, 4 on her upper left, and obviously needs special attention to having everything floated.

If you want to look for a silver lining . . . years later, she developed gutteral pouch mycosis, a life-threatening condition that can cause the horse to hemorrhage fatally through its nose. I caught it very early, before any bleeding, and she had successful surgery. The only reason I caught it so soon, was that after the sinus infections, the first thing I did every day at the barn was to stare and sniff at her nostrils!

BTW following all these travails, the mare went on to foxhunt for several seasons, still does WTC lessons aged 23, and is the boss of her 7-mare paddock.

[teal tea]

LOL, Martha. Yeah I have gotten into the habit of leaning into my mare's right nostril to gauge how bad the smell was that day.

I hope she ends up looking ok after this. However her looks are the least thing for me to worry about right now.

[2tempe]

Teal Tea - she will only look bad for a while- slightly reminding you of Frankenstein..! Once the incision heals, she'll look fine. Just an FYI, my mare's incision had some weeping/draining which was not unexpected. It did a job on some of her facial hair below the incision; in hindsight it probably would have helped if I put some vasiline on the area below to protect it. But that also resolved itself over time.

[Martha Drum]

Note that 2tempe and I both went through this 10+ years ago, so technique can only have improved in that time.

[tuppysmom]

We have a TB gelding who has had sinus flap surgery on both sides of his face within a year and then had to have holes drilled and flushing on the original side a year later. It has now been 1 year and almost a month since the last procedure and all is well so far.

His costs to date are 10k plus. There were lots of antibiotics and anti fungal meds along with the surgeries. I am glad that we continued on and finally have him dry and sweet smelling again. He is back competing and doing well.

Best of luck to your horse!

[teal tea]

Surgery today at 1 or 2 pm. I hope all goes well. She has kept up a great attitude and work ethic despite her problem which surely has to have bothered her.

[Auburn]

Sending jingles from KY that her surgery and follow up is a piece of cake.

[Martha Drum]

Good luck! Hope it goes well.

[SanJacMonument]

Jingles!