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C-flap sinus surgery - experiences?

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  • C-flap sinus surgery - experiences?

    If your horse has gone through c-flap sinus surgery to debride the bone and remove infection, can you tell me how that went?

    Were they able to do it standing or was general anesthesia required? (I know it can be done both ways -- just curious about reasons one way or another may have been chosen in specific cases.)

    What was the long-term success of the operation?

    My mare has a history of sinus infection problems and c-flap surgery is looking increasingly likely. I'm feeling exceptionally pessimistic at this point about long-term resolution, and am questioning if the cost/risk of a c-flap surgery are worth it if we end up in the same place in six months or a year.

    And yes, all my concerns will be discussed in detail with my vet. I'd just appreciate anecdotes/food for thought at the moment.

  • #2
    Have you already tried a simple trephination with flushing? Usually that is tried first before a bone flap. Which sinuses are affected (you can't trephine all sinuses)?


    • Original Poster

      When all of this started, we flushed repeatedly over the course of about six months, tried antibiotics, flushed with antibiotics, etc. She had surgery then, but it was with two trephination holes and a scope to guide flushing. Based on what they saw then, we thought we had found/broken up/cleared out the source of the recurring infection.

      All looked good for about 9 months and then symptoms started reoccurring. We're flushing again now, but the xrays show a lot of fill in the sinus and there is simply not enough gunk coming out with the flushes to make my vet or I happy. We suspect at this point that the infection is rooted in the bone, and will probably be making a decision about sending her to Texas A&M tomorrow. One of the reasons for sending her up to A&M is that my vet's scope cannot navigate the sinus well enough to determine the actual extent of the infection, and A&M has a much better one for that.


      • #4
        Oh man! Jingles for your girl!! Hopefully they can open up the nasomaxillary aperture so it'll drain a little better and get rid of any necrotic bone that's in there.


        • #5
          We went thru a year and a half of antibiotics, flushing, then surgery, bone infection, more flushing, and then a rare fungal infection. He was like a bad science project. The horse should hate me for all we did to him. He was needle phobic besides. Poor guy. However today he is 24 and quite healthy. He gets soaked beet pulp in the winter to help keep some weight as he is short teeth now. On summer grass he is fine without extra. I quit counting the dollars so I really can't give a good estimate of cost. I was quite pessimistic too but glad we went forward with it. It really could have gone either way so there really is no right or wrong answers. Jingles not only for your mare but for you having to decide what to do.


          • #6
            Have you tested for metabolic issues? Horse at my barn had constant sinus infections and all the antibiotics in the world wouldn't help. That is until the horse was diagnosed with cushings, put on pergolide WITH antibiotics....infection GONE!

            Kiwayu & Figiso Pictures:


            • Original Poster

              Thanks everyone. I think I've read enough to realize there are too many variables to try to predict anything at this point, so I'm trying not to get ahead of myself. Unless my vet is very optimistic about our current treatment the next time we talk, I'm definitely leaning towards A&M at this point. Beyond that - I'll have to talk to the vets up there.

              Kiwayu, I don't think we've ever talked about metabolic issues. There's nothing about her that would suggest a problem to me. I can ask my vet, but I suspect he'll say the same thing.

              Fortunately the sinus infection doesn't seem to bother her and she's really very good about treatments.


              • #8
                Two of the horses in our neighborhood had flap surgery to remove big cysts in the sinuses. Both did well. I would think heading to Texas A and M is your best option.


                • Original Poster

                  Oh, definitely. It's a question of timing at this point, since we want certain things to happen before we send her up. But as soon as they do, she's going up. Little Miss Medical Mystery made sure of that.


                  • #10
                    Mr. Studly had sinus flap surgery to remove a tumor when he was around 20 (a couple years ago). He had general anesthetic and recovered well from the surgery. The bone healed well with very little scarring. I know another horse who had the same surgery around the same time at the same vet school and had lots of problems following it. His was for infection like you described in your horse.
                    With that said, Mr. Studly's tumor came back and he was put down in January. The other horse is doing fine now.
                    Good luck!
                    Y'all ain't right!


                    • #11
                      My horse had maxillofacial flap surgery and came out fine -- he had a huge cyst in his sinus. Just follow the dr's instructions -- it heals very quickly!
                      Dressage, riding, sport horse blog
                      Unique browbands for dressage and hunter riders


                      • Original Poster

                        Bumping this up to thank everyone again for responding and updating for anyone who might be interested.

                        My mare went up to A&M last week. She had a sinus cavity full of inspissated pus but no cyst or tumor. The surgery went very well. I have to say, the surgeons/vet students/staff at A&M were fabulous.

                        She's home now and we're on to the aftercare/recovery bit. Hopefully, this will be the end of the sinus roller coaster for us.


                        • #13

                          My Hanoverian had a bone flap surgery on March 31st. How long until you can start working them and building them back up. I was hoping to get her inspected this year. We walk miles up and down hills together to keep her some what in shape!


                          • #14
                            My horse had c-flap surgery recently to remove a large cyst in his sinus. He was on small paddock turn out for two weeks, then full turn out in the big field with his friend for two weeks, and clear to go back to work after a month. it's now been 8 weeks and while there is still some drainage from the nostril, you'd never know he had the surgery to look at him unless you looked closely and knew what you were looking for. It healed incredibly well, and fast. I hand walked him for the month he was off, and he was in very good shape going into the surgery, and was back to full work within 6 weeks. It was done standing.