Recent surgeries

Nasal septum tumour

This gelding developed a squamous cell carcinoma at the front end of his nasal septum. This tumour needed removing with a good margin to prevent recurrence. Removing the front end of the septum was impractical because of the risk of bleeding in surgery and the problem of postoperative swelling which naturally forms at the site of removal which would cause noise and/or airflow compromise during exercise.

Blood loss in surgery is the most serious risk. We were able to borrow a healthy gelding for the day to act as a blood donor, and had around a gallon of cross matched blood ready to give the horse during the bloodiest part of surgery.

First stage of surgery was carrying out a tracheostomy so the horse could breathe well away from the surgery site. Wires were then threaded around the back, upper and lower three sides of the septum ready for cutting using long instruments and an endoscope to help.

Once all 3 wires were in place they were used to simultaneously cut the septum out. The front edge was cut with a scalpel. The nasal cavity was then packed with a bandaging in a sterile sock to stop the bleeding, and the nostrils sutured completely closed. The blood transfusion was also carried out at this stage.

The horse made a very good recovery, although was unable to make any noise at all thanks to his sutured nostrils and tracheostomy. All the packing was removed 2 days later. Local chemotherapy was carried out near where the tumour had been to minimise the risk of tumour regrowth. When he same back for his 3 month checkup his owner was able to report that he was completely back to normal and showed no ill effects of having lost the septum. Internally he only has one cavity rather than 2, as seen on endoscopy.

Removing the whole septum is very rarely carried out in the UK. The most common indication is fungal infections which only happen in warmer climes. Happily the technique worked beautifully and the horse has returned completely to normal.