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Summary: Sinoscopy consists of direct visualisation of the paranasal sinuses and was first conceived for diagnostic purposes using a rigid endoscope through a skull trephination. Since then, the use and approaches to perform it have evolved thanks to current advancements in knowledge (sinus anatomy and pathology) and technology. The aim of this article is to review the techniques reported to perform traditional and minimally invasive sinoscopy and to review the current use of sinoscopy to treat paranasal sinus disease. The history of sinoscopy, as we know it today, is relatively recent, but its use among clinicians is not necessarily widespread despite the invasiveness of the traditional technique when compared to imaging techniques. This limitation could be bypassed using the newer intranasal or extranasal minimally invasive sinoscopic approaches. These techniques allowed sinoscopic visualisation through natural orifices or minimally invasively created openings. Despite the potential of these techniques, case selection is still crucial as visualisation can be limited in selected disorders (i.e. sinus cyst), some sinuses (i.e. rostral maxillary with intranasal approaches) and if haemorrhage or severe exudate accumulation is found. Nevertheless, sinoscopy offers a diagnostic rate superior to traditional imaging and it is an alternative diagnostic tool when advanced imaging techniques, such as CT, are not available. In recent years, sinoscopic treatment has been progressively replacing the use of sinusotomies to treat most sinus disorders. Sinoscopic treatment yields a high‐resolution rate while complications are kept low. Familiarisation with sinoscopic techniques and in‐depth anatomic sinus knowledge will likely make sinoscopy the gold standard technique to treat sinus disease in the near future. [ABSTRACT FROM AUTHOR]

Background: Publications about equine standing surgery are flourishing, however, information regarding its use and prevalence among surgeons is still limited. Objectives: To determine the current use and recent trends for equine standing surgery among board certified surgeons and to identify the main reasons and limitations for performing a procedure standing. Study design: Cross‐sectional survey. Methods: A 139‐item questionnaire was sent by email to 733 large animal surgery Diplomates (ACVS and ECVS) from November 2020 to February 2021. The survey collected demographic information and general data regarding standing surgery before being divided into seven identical sections for each body system, involving 36 standing procedures. Results: The survey response rate was 29.7% (218/733). Most respondents (58.9%, 126/214) had performed standing surgery for <10 years regardless of length of time they were board certified (48.2% board certified <10 years and 51.8% >10 years). Most respondents (range: 50.0%–92.9%, mean 69.5%) changed from performing 14/36 surgeries under general anaesthesia (GA) to standing within the previous 10 years and had always performed 8/36 surgeries standing (51.6%–73.9%, mean 61.4%) regardless of board certification time. Surgeons board certified <10 years ago performed more often 3/36 listed procedures standing than those board certified >10 years ago (p < 0.05). Avoiding GA (179/218) and/or reducing procedure cost (111/218) were the two main reasons to perform standing surgeries whereas the horse's behaviour (183/218) and/or the patient size/age (94/218) were the two main limiting factors. Main limitations: Low response rate. Results biased towards the opinion of a subgroup of surgeons, those performing standing surgery. Some standing procedures were not included in the survey. Conclusions: The use of standing surgery is well established among board certified surgeons and progressively increasing, especially in the last 10 years and among recent Diplomates. With increased training and awareness, more Diplomates may be encouraged towards performing standing surgeries. [ABSTRACT FROM AUTHOR]

Background: The effect of intrathecal anaesthesia of the carpal sheath on distal forelimb sensitivity in horses remains unknown. Objectives: To assess the effect of carpal sheath anaesthesia on skin sensitivity of the distal forelimb and to determine potential locations for desensitisation of palmar nerves. Study design: In vivo experimental and descriptive anatomical studies. Methods: Mepivacaine hydrochloride 2% (0.6 mg/kg) was injected unilaterally in the carpal sheath of 8 horses. Mechanical nociception of the distal forelimb was measured with a dynamometer and compared with the control limb at t0, t15, t30, t60, t90, t120 and t180 minutes. Additionally, the carpal sheath of 10 pairs of cadaveric limbs was injected with latex and potential locations for anaesthetic diffusion to the neighbouring nerves were identified during longitudinal dissection (one limb) and in 3‐cm‐thick transverse cuts (opposite limb). Results: Six of 8 horses (75%) were completely desensitised at the level of both heel bulbs. Anaesthetic injection was not smooth in the 2 horses without desensitisation. Desensitisation started between 30 and 60 minutes in 67% of desensitised heel bulbs (8/12), and 50% (6/12) of them were still completely desensitised at 180 minutes. Cadaveric specimens revealed close proximity between the sheath and the medial palmar nerve as it travels inside the mesotenon of the digital flexor tendons in the carpal region and with both palmar nerves at the proximal metacarpal region. Main limitations: Skin mechanical nociception does not necessarily correlate with deep pain but remains the main clinical tool used by practitioners to assess distal limb anaesthesia. Conclusions: Intrathecal anaesthesia of the carpal sheath led to distal limb skin desensitisation through diffusion to the palmar nerves at 2 possible locations. Carpal sheath anaesthesia should be interpreted within 15 minutes following injection and anaesthetic blocks distal to the carpus should be delayed for more than 3 hours following carpal sheath anaesthesia. [ABSTRACT FROM AUTHOR]