Description
Advances in Sinus Surgery by Tim Barnett. Sinus surgery, as with many other field of equine surgery, has evolved over the past few years with a greater emphasis on minimally invasive techniques. Sinoscopic approaches using rigid telescopes or flexible endoscopy has become the first line treatment, replacing traditional osteotomy techniques, in many cases. Instruments can be inserted through the same portal, a second portal or via the biopsy channel of a flexible endoscope, facilitating debridement and removal of diseased tissue. Fenestration of the maxillary septal bullae and the conchal bullae can also be achieved using the minimally invasive approach, facilitating increased access and drainage from the sinuses. Diagnosis of sinus disease has been revolutionised by modern three-dimensional imaging of the head, including computed tomography (CT) and magnetic resonance imaging (MRI). The former of which is now available in a number of referral centres in the UK with the ability to exam the horse standing using sedation, negating the need for a general anaesthetic. CT has been particularly useful in the diagnosis of dental-related sinusitis and surgical planning of mass removal from the sinuses. Tim qualified from the University of Edinburgh in 2005 and began working as a general practitioner at Swanbridge Veterinary Group in East Yorkshire. He moved to Rossdales, Newmarket in 2007, working initially as an orthopaedic diagnostic assistant and then completed an 18-month internship. In 2010 he embarked upon a surgical residency at Edinburgh University. Tim returned to Rossdales in 2013 and spends his time working within the hospital surgical team. As well as emergency admissions, he sees a wide variety of elective cases and has a particular interest in upper airway and dental conditions.