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Validation of a 2‐mm videoendoscope for the evaluation of the paranasal sinuses with a minimally invasive technique
Author(s) -
Pouyet Morgane,
G. Bonilla Alvaro
Publication year - 2020
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/vsu.13269
Subject(s) - cadaveric spasm , medicine , endoscope , paranasal sinuses , sinus (botany) , endoscopy , frontal sinus , anatomy , surgery , biomedical engineering , radiology , botany , biology , genus
Objective To describe the technique, experience, and limitations of using a 2‐mm flexible endoscope to perform standing minimally invasive sinoscopy. Study design In phases 1 and 2, we used cadaveric heads (ex vivo). In phase 3, we used unaffected horses (in vivo). Animals Five cadaveric equine skulls in phase 1 and 10 cadaveric equine skulls in phase 2. Six horses older than 5 years in phase 3. Methods In phase 1, the specimens were used to determine the suitability of the endoscope for sinoscopy and the ideal landmarks to approach the paranasal sinuses through minisinusotomies performed with a 14 gauge needle. In phase 2, a nonblinded evaluation of the visualization of the different sinus compartments was performed, and a score was attributed to each structure. Procedures were video recorded and compared with direct visualization of the sinuses after performing frontal and maxillary flaps. In phase 3, the technique was validated in healthy horses under sedation. Results The landmarks determined in phase 1 allowed a thorough exploration of the sinuses in phases 2 and 3. Sinoscopy findings were confirmed after direct visualization of the sinuses via frontal and maxillary bone flaps in phase 2. The procedure was well tolerated by all horses. Conclusion Minimally invasive sinoscopy was readily performed without relevant complications in standing horses. A thorough evaluation of most sinus structures was obtained only using the frontal and the rostral maxillary portals. Clinical significance Minimally invasive sinoscopy offers an alternative diagnostic tool to veterinarians. A specialized endoscope and appropriate training are required to perform this minimally invasive procedure.