Nasal Sinus Drainage and endoscopy PRACTICAL Flashcards
1
Q
How do you perform a frontal nasal sinus drainage?
A
- Clip
- 2cm caudal from medial canthus incision through skin
- Second cut is rostral to facial crest (bony ridge, palpable on side of face)
- Join the two cuts up to create a three sided flap
- Retract the skin, preserve periosteum
- Drill into the bone to create a flap of bone
- Flush with water to stop heat necrosis
2
Q
Where are the forceps inserted here?
A
Forceps in frontal sinus
3
Q
Where are the forceps inserted here?
What can you feel here?
A
- Forceps in caudal maxillary
- Can feel tooth roots here
4
Q
Where are the forceps inserted here?
A
- Forceps in rostral maxillary sinus
5
Q
Where do all sinuses drain into?
A
- All drain into middle nasal meatus
6
Q
In a horse with sinusitis, before you go to doing a frontal sinus flap and drain, what should you try before hand?
A
- Try antibiotic
- Trefine into frontal sinus and drain
- If going to drain would radiograph first to see fluid line and trefine in this area
- Exercise to increase drainage
- Constricts mucosa making it easier to breathe
- Feed from ground to aid drainage
7
Q
How should you sedate a horse for performing this ansal sinus drainage?
What about LA?
A
- LA supraorbital nerve block
- Sedation: A2 and opioid
- Use a drip rather than bolus so steady sedation
8
Q
Which sinus has a cnig communication with the frontal sinus?
A
- Caudal maxillary
- Big communication with frontal sinus
9
Q
A
10
Q
What are the left and right guttural pouches divided by?
A
- L and R guttural pouches
- Divided by stylohyoid bone into lateral and medial compartments
11
Q
What cranial nerves are in the guttural pouch?
A
CN 9, 10, 11 (glossopharyneal, vagus, accessory)
12
Q
Other than the cranial nerves, what other major structures can you find in the guttural pouch?
A
- external maxillary, internal carotid arteries inside guttural pouch
- Internal carotid is in medial compartment of pouch
