Lateral rhinostomy for treatment of severe chronic rhinosinusitis in two rabbits

CASE DESCRIPTION 2 client-owned rabbits were evaluated for signs of chronic upper respiratory tract disease. CLINICAL FINDINGS Clinical signs had been present for 3 weeks and 4 years and included mucopurulent nasal discharge, right-sided maxillary swelling, recurrent dacryocystitis, and intermittent sneezing. One rabbit had been treated with nasolacrimal duct lavage and topical and systemic antimicrobial administration without resolution of clinical signs. Results of CT of the head in both cases indicated severe rhinosinusitis. TREATMENT AND OUTCOME Both rabbits underwent unilateral rhinostomy by means of a lateral approach. Access was established via the facies cribrosa of the maxillary bone. Purulent material was removed from the affected nasal cavity and the maxillary sinus by means of debridement and lavage. After endoscopic exploration, marsupialization was performed to create a stoma. Both rabbits recovered from surgery without apparent complications, and the surgical site healed within 1 month in both. Computed tomography was repeated 5 months after surgery in one rabbit and 13 months after surgery in the other and indicated patent nasal passages and no evidence of recurrence or persistence of disease. CLINICAL RELEVANCE Results suggested that lateral rhinostomy should be considered for treatment of chronic severe rhinosinusitis in rabbits. Such an approach may be less technically demanding and could decrease the likelihood of postsurgical complications reported with other techniques.

Effects of fibrin sealant-containing antibiotics in a rabbit model of chronic sinusitis

Postoperative complications of sinus surgery include bleeding, infection, and synechiae. Improved subjective outcomes in humans treated with fibrin sealant (FS) after endoscopic sinus surgery (ESS) have been reported. Streptococcus pneumoniae was used to initiate chronic sinusitis in occluded rabbit sinuses in order to evaluate the role of FS in mucosal healing. Six weeks later, all animals had maxillary antrostomies. Homologous FS-containing ciprofloxicin (100 mg/mL) and clindamycin (15 mg/mL) was applied topically to treatment rabbits (n = 9). Control rabbits (n = 10) received no antibiotics. Two weeks into the recovery phase after antrostomies, all animals were re-examined. Mucociliary transport velocity (mean +/- standard deviation in mm/minute) was measured in all sinuses (n = 38) during healthy (100% measurable, 13.82 +/- 4.16), infected (18% measurable, 4.74 +/- 0.42), and recovery phases (5% measurable, 6.30 +/- 4.67). In both groups, mucopurulent discharge was present in the majority of sinuses (control group 18/20, FS group 16/18). In addition, there was no significant difference in the recovery phase between the two groups when comparing changes in the size of antrostomies, light microscopy, or culture clearance. Scanning electron microscopy did suggest a possible improvement in ciliary regeneration in the FS group. Application of FS-containing antibiotics did not appear to improve healing after ESS in our rabbit model of chronic sinusitis.