Endoscope-assisted three-wire technique for extensive nasal septum resection in horses

ObjectiveTo describe a 3-wire method with endoscopic guidance for extensive nasal septum resection.Study designRetrospective study.Sample populationThirteen horses with nasal septum diseases.MethodsIn anesthetized horses in left lateral recumbency, endoscopic guidance was used to place obstetrical wires for the ventral and caudal incisions in the nasal septum and a trephine opening was used to place the dorsal wire. The rostral aspect of the septum was incised with a scalpel, followed by incisions with the preplaced wires, and the nasal passages were packed with gauze. Horses were recovered with a temporary tracheotomy.ResultsConversion to intraoral placement of wires was required in two horses, one to correct entangled wires and the other because hemorrhage obscured the endoscopic view. Exercise tolerance was improved postoperatively, abnormal respiratory noise was decreased or eliminated by surgery in all horses, and all owners were satisfied. One Thoroughbred racehorse performed with modest success.ConclusionsModification of the 3-wire method was effective and safe for extensive nasal septum removal. Technical complications of the procedure include entangling of wires and intraoperative hemorrhage.Clinical significanceEndoscopic guidance can be used to place obstetrical wires for nasal septum resection in small horses and precludes use of a large tracheotomy for anesthetic delivery. Reasons for athletic failures were difficult to establish retrospectively, although assessment of postoperative noise at speed might be more relevant to recovery of athletic potential than assessment at slower gaits.