A Dorsal Approach for the Removal of the Nasal Septum in the Horse RYAN W. SHOEMAKER, DVM, MVSC, DIPLOMATE ACVS, DAVID G. WILSON, DVM, DIPLOMATE ACVS, and PETER B. FRETZ, VMD, DIPLOMATE ACVS Objective—To describe and evaluate a technique involving a dorsal approach for the removal of the nasal septum in adult horses. Study Design—Retrospective clinical study. Animals—Four client-owned horses. Methods—Access for partial nasal septum resection was through a dorsal nasal bone flap. Septum resection was performed because of reduced airflow from septal deviation and/or thickening caused by traumatic insult or neoplasia. Preoperative clinical signs and diagnostic results were recorded. Intra- and postoperative complications were noted and follow-up information was obtained from telephone interviews of owners or by clinical examination. Results—The abnormal segment of the nasal septum was completely removed in all horses. A dorsal nasal bone flap approach provided excellent access to the septum and allowed immediate control of hemorrhage; blood transfusion was not needed. Cosmetic results were considered good to excellent by owners and horses returned to their previous level of work without perceived limitations associated with airway function. Conclusions—Nasal septum resection by the dorsal approach permits good observation of the abnormal septum, and provides exposure that facilitates removal of nasal masses and reduction of depression fractures with minimal complications. Clinical Relevance—A dorsal nasal bone flap approach should be considered for horses that require nasal septum resection because it can be achieved with minimal hemorrhage, good cosmetic results, and return to function. r Copyright 2005 by The American College of Veterinary Surgeons Key words: nasal septum resection, nasal passages, operative hemorrhage, horse. INTRODUCTION F RACTURES OF the nasal cavity most commonly involve the nasal or frontal bones in the horse. 1 The equine frontal, nasal, and maxillary bones are thin, have little cortical mass, and relatively minimal soft-tissue cover, 2 which, combined with their anatomic location, makes them most vulnerable to fracture by direct trauma (kick, fall, collision, or struggle). 2 A complication of trauma can be nasal septum deviation 3 or thickening secondary to fracture. 4 Nasal septal resection is indicated when nasal airflow is reduced because of septal disease or lesions within the nasal passages. 5 Airflow obstruction secondary to trauma is the most common reason for nasal septum resection in the horse. 6 Five surgical procedures have been described for nasal septum resection in horses. 1,5–8 Two methods involve creation of a trephine hole through the nasal bones near the caudal aspect of the septum and septum removal by a nasal approach using either obstetrical wire or a guarded Address reprint requests to Dr. Ryan W. Shoemaker, Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada S7N 5B4. E-mail: shoemaker@usask.ca. Submitted May 2005; Accepted August 2005 From the Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. r Copyright 2005 by The American College of Veterinary Surgeons 0161-3499/04 doi:10.1111/j.1532-950X.2005.00104.x 668 Veterinary Surgery 34:668–673, 2005