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Salvage frontal sinus surgery: the endoscopic modified Lothrop procedure.
1Department of Surgery, Section of Otolaryngology Head and Neck Surgery, Adelaide and Flinders Universities, Adelaide, South Australia, Australia. peterj.wormald@adelaide.edu.au
The Laryngoscope
|February 5, 2003
Summary
The endoscopic modified Lothrop procedure is a successful treatment for severe frontal sinusitis, offering a high success rate and avoiding traditional surgery. This approach effectively manages complex cases, including those with complications and fungal infections.
Area of Science:
- Otolaryngology
- Neurosurgery
- Endoscopic Sinus Surgery
Background:
- The osteoplastic flap with frontal sinus obliteration was the standard for recalcitrant frontal sinusitis.
- The endoscopic modified Lothrop procedure is an emerging alternative.
Purpose of the Study:
- To evaluate the efficacy of the endoscopic modified Lothrop procedure for treating recalcitrant and complicated frontal sinusitis.
Main Methods:
- A prospective, non-randomized interventional case series assessed 83 patients undergoing the endoscopic modified Lothrop procedure.
- Patients had a history of multiple sinus surgeries, frontal sinus obliteration, or complications like intracranial mucocele extension, orbital issues, and CSF leaks.
- Fungal sinusitis was present in 30% of patients.
Main Results:
- The procedure achieved a 93% primary success rate, with only 7% developing frontal ostium stenosis, managed by revision surgery.
- Recurrent symptoms occurred in 25% of patients, with fungal sinusitis noted in 9 patients; however, ostia remained patent.
- No patients required conversion to an osteoplastic flap procedure.
Conclusions:
- The endoscopic Lothrop procedure is a successful short-term management option for recalcitrant and complicated frontal sinusitis.
- It effectively addresses a wide range of frontal sinusitis etiologies, including fungal infections and post-surgical complications.
