Trephination and the Seldinger technique achieve comparable sinonasal distribution of clotrimazole cream in canine cadavers.

OBJECTIVE

To compare the volumetric distribution of clotrimazole cream within the sinonasal cavities of cadaver dogs using frontal sinus trephination or the Seldinger technique.

METHODS

Cadaver dogs with normal sinonasal cavities underwent frontal sinus trephination or the Seldinger technique in this prospective experimental study between October 2022 and March 2023. Contrast-enhanced clotrimazole cream was instilled into the sinonasal cavities, and distribution was assessed using CT. Volumetric measurements were performed using open-source medical imaging software spanning regions from the frontal sinus, cribriform plate, canine tooth, and maxillary premolar 4 to the naris.

RESULTS

25 cadaver dogs were enrolled; 22 met the inclusion criteria, and 3 cadavers were excluded (1 due to intracranial penetration via trephination). Both techniques achieved excellent frontal sinus filling (> 75%). Mean instillation volumes required for ipsilateral naris filling increased with body weight: 2.4 ± 0.2 mL/kg (cadavers < 10 kg), 3.0 ± 0.2 mL/kg (cadavers 10 to < 20 kg), 3.6 ± 0.2 mL/kg (cadavers 20 to < 40 kg), and 4.5 ± 0.6 mL/kg (cadavers > 40 kg). Computed tomography-guided measurements were required for cadavers < 20 kg to minimize complications during trephination.

CONCLUSIONS

The Seldinger technique achieved sinonasal filling comparable to trephination in healthy cadavers. The volume of cream required varies for patient weight groups.

CLINICAL RELEVANCE: Both techniques achieved comparable sinonasal clotrimazole filling; however, procedural feasibility may be influenced by small‑breed cadavers and those with normal sinonasal anatomy. Further studies in live patients are required to determine procedural feasibility, complication rates, and effectiveness.