Alleviation of Epiphora by Canaliculosinostomy into the Caudal Maxillary Sinus in the Horse

Abstract

This report describes a simple technique for canaliculosinostomy into the caudal maxillary sinus and long-term outcome in 4 of 5 horses, all of which had resolution of epiphora. This technique can be used to resolve epiphora of various etiologies.

Fluoroscopically guided neocanalization for treatment of nasolacrimal atresia in two horses

“…In future patients, suturing the stent through a full‐thickness incision in the naris (ie, a false nostril) may mitigate the potential for dislodgement during healing. The need for stent placement and retention during wound healing is not unique to this procedure and is necessary for most neocanalization methods …”

“…Because access is image‐guided in real time, the procedure described in the present study may be used to treat atresia at any point along the NLD which is not fully encased in bone, offering an advantage over traditional surgery. In addition, it affords visualization of the nasal cavity in a way that is typically not possible during other procedures such as caudal maxillary canaliculosinostomy …”

“…While an imperforate nasal punctum is the defect most often described, atresia can occur anywhere along the course of the NLD . Foals presenting with this condition exhibit epiphora which progresses to mucopurulent ocular discharge with the onset of secondary bacterial dacryocystitis …”

“…When the point of atresia is more proximal or otherwise inaccessible, the length and narrow profile of the equine nasal cavity can prevent traditional surgical techniques . Alternative techniques such as canaliculosinostomy, establishment of a permanent drainage tract from the canaliculus into the caudal maxillary sinus, have also been described . While these have shown success in re‐establishing lacrimal drainage, some techniques require more invasive osteotomies which result in prolonged healing times and the potential for greater cosmetic changes postoperatively .…”

“…3,4 Foals presenting with this condition exhibit epiphora which progresses to mucopurulent ocular discharge with the onset of secondary bacterial dacryocystitis. 3,5,6 Dacryocystorhinography (DCG) with instillation of contrast medium into the nasolacrimal ducts is commonly performed to better characterize the location and nature of the obstruction. 4,7 DCG may be performed radiographically in the standing, sedated animal, or by computed tomography (CT) under general anesthesia.…”