Surgical therapy and long‐term outcome of sinus pneumocele in a miniature Shetland pony

Summary A 2‐year‐old Miniature Shetland Pony gelding was presented with a 4‐month history of nasal stridor and nasal discharge. Computed tomography revealed a large, air‐filled deformation of the left paranasal sinuses with thinning and upward displacement of the frontal bone, deviation of the nasal septum and complete obstruction of the left nasal meatus. A diagnosis of sinus pneumocele was made based on the accumulation of air and secondary bone atrophy. Surgical decompression was performed via a left‐sided conchofrontal bone flap, allowing resection of the distended conchal walls and creation of a new sinunasal communication. Postoperative recovery was uneventful, and respiratory function normalised immediately after surgery. Endoscopic follow‐up examinations confirmed progressive mucosal healing and near‐complete bony reconstruction of the frontal defect within 4 months. Three years postoperatively, the pony remains clinically sound and is used successfully for competitive driving. This is the first report describing surgical treatment and long‐term outcome of a sinus pneumocele in a Miniature Shetland Pony. The excellent functional and cosmetic results emphasise the importance of an immediate surgical intervention and careful selection of the surgical approach for this rare condition.