Nasal Septum Resection

If the nasal septum—the bony structure that divides the left and right halves of the nasal cavity—becomes deviated or thickened, the nasal passages become narrowed and breathing is impaired. Left untreated, it can lead to exercise intolerance and respiratory distress. In severe cases, resection or surgical removal of the nasal septum is required to restore normal airflow. While this type of procedure has been performed for more than a century, a report was recently published from the University of Illinois (at Urbana-Champaign, UIUC) College of Veterinary Medicine describing a new method of nasal septum resection.

Aimie Doyle, DVM, MS, of West Wind Veterinary Hospital, Ltd. in Sherwood Park, Alberta, Canada, and David Freeman, MVB, PhD, Dipl. ACVS, assistant professor in equine medicine and surgery at UIUC, described the new procedure, which uses three pre-placed obstetrical cutting wires to remove the entire nasal septum. Doyle explains, “The idea was to design a procedure that was easier and faster in order to minimize hemorrhage and trauma to adjacent structures that was common with the previous chisel and hammer method.”

Five horses with signs of respiratory distress had the procedure performed. All had evidence of thickening and/or deviation of the nasal septum. Three lengths of obstetrical wire were placed along the ventral (bottom), dorsal (top), and caudal (back) borders of the nasal septum. The ventral and dorsal wires were passed by hand through the left nostril, around the free caudal edge of the septum, and out the other side. A 1.5 cm hole was made through the facial skin and bone, with a circular sawing instrument called a trephine hole, to allow ac-cess to the caudal edge of the septum, where the third wire was dropped into place. “This caudal cut was the most difficult using the old method,” says Doyle. “It often resulted in swelling of the stump left behind, causing respiratory obstruction and distress.”

The rostral (front) edge of the septum was cut manually, reaching through a nostril, to ensure that at least 5 cm of septum was left in place to support the nostrils and alar (flat, wing-shaped process) folds between them. The three wires were used in a sawing motion to cut the septum as quickly as possible. The septum was removed with forceps through a nostril and the nasal cavity packed with bandage material to control bleeding.

The outcome of surgery was excellent in four of the five horses. The fifth horse, diagnosed with a congenital wry (abnormally twisted or bent) nose, experienced deviation of the remaining septum, producing exercise intolerance during race training, requiring the horse to retire.

Doyle, A.J.; Freeman, D.E. Extensive Nasal Septum Resection In Horses Using A 3-Wire Method. Veterinary Surgery, 34: 167-173, 2005.

About the Author

Susan Piscopo, DVM, PhD

Susan Piscopo, DVM, PhD, is a free-lance writer in the biomedical sciences. She practiced veterinary medicine in North Carolina before accepting a fellowship to pursue a PhD in physiology at North Carolina State University. She lives in northern New Jersey with her husband and two sons.

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