Osteoplastic flap versus modified endoscopic Lothrop procedure in patients with frontal sinus disease

The aim of the present study was to review the clinical results of osteoplastic flap procedure with abdominal fat obliteration and modified endoscopic Lothrop procedure. Charts of patients with frontal sinus disease who underwent osteoplastic flap procedure with abdominal fat obliteration or modified endoscopic Lothrop procedure were retrospectively reviewed. Forty-three patients with frontal sinus disease underwent osteoplastic flap procedure with abdominal fat obliteration. Frontal sinus disease was chronic sinusitis in 21, mucocele in 18, and papilloma in four. None of the patients had recurrence within 3 to 12 years follow-up period. Six patients had decreased forehead sensation, one had a CSF leak, and one had loss of the fat graft. Fifteen patients with chronic frontal sinusitis underwent modified endoscopic Lothrop procedure. The follow-up period ranged from 0.5 to 2.5 years. Two patients had recurrence of disease 2 and 6 months after surgery and required osteoplastic flap. In patients with chronic frontal sinusitis, both procedures achieved good relief of symptoms; however, follow-up time of modified endoscopic Lothrop procedure was smaller than that of osteoplastic flap procedure. In conclusion, osteoplastic flap procedure with abdominal fat obliteration provides successful treatment in patients with frontal chronic sinusitis, mucocele, or papilloma. Modified endoscopic Lothrop procedure achieves the relief of symptoms in patients with chronic frontal sinusitis. With the future availability of long term follow-up results, modified endoscopic Lothrop procedure may reduce the number of osteoplastic flap procedures in patients with chronic frontal sinusitis.