Current methods of creating sinus drainage and allowing egress of a sinus pack at the end of surgery create significant haemorrhage. Given that haemorrhage is already a concern in some sinus surgeries, the method described allows for a significant reduction in blood loss. The objective was to describe a method of enlarging the nasomaxillary aperture in horses to allow egress of a sinus pack, and subsequent endonasal treatment, without incurring significant haemorrhage. The bulla of the maxillary septum is depressed using a gloved finger (through a sinus flap or trephine hole) or using a long curved Peine instrument under sinoscopic control before fenestration. No major operative or post-operative complications have been encountered. Satisfactory widening of the nasomaxillary aperture has been accomplished in all cases, although at times, when the bulla is under the floor of the dorsal conchal sinus, it can be difficult to compress. It is imperative that this procedure be performed before fenestration. If performed after fenestration, the most rostral edge of the fenestration can be difficult to identify, and this becomes an impediment to widening the nasomaxillary aperture. Enlarging the nasomaxillary aperture with a finger or blunt instrument allows improvements in sinus drainage without the complication of severe epistaxis. Depression of the bulla of the maxillary septum, before surgical fenestration into the rostral maxillary and ventral conchal sinuses, allows opening of the nasomaxillary aperture with minimal haemorrhage. Thereafter, the sinus pack can be egressed via this route, which is also large enough to perform sinus lavage and post-operative treatments endonasally without the risk of disturbing the external surgical site.

中文翻译：

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术中压低上颌中隔大泡作为改善马鼻窦引流的方法

目前在手术结束时产生鼻窦引流和允许鼻窦包排出的方法会造成大量出血。鉴于在某些鼻窦手术中出血已经成为一个问题，所描述的方法可以显着减少失血量。目的是描述一种扩大马的鼻上颌孔以允许鼻窦包排出的方法，以及随后的鼻内治疗，而不会引起明显的出血。在开窗前使用戴手套的手指（通过鼻窦瓣或环钻孔）或在鼻腔镜控制下使用长弯曲的 Peine 器械压低上颌中隔的大泡。没有遇到严重的手术或术后并发症。在所有情况下都实现了令人满意的鼻上颌孔径扩大，尽管有时，当大泡位于背耳甲窦底下时，可能难以压缩。必须在开窗前执行此程序。如果在开窗后进行，开窗的最前缘可能难以识别，这成为扩大鼻上颌孔的障碍。用手指或钝器扩大鼻上颌孔可以改善鼻窦引流，而不会出现严重鼻衄的并发症。在手术开窗进入上颌和腹侧耳甲窦之前，压低上颌中隔的大泡，允许以最小的出血打开鼻上颌孔。此后，窦包可以通过这条路线离开，