Related Experiment Videos
The modified endoscopic Lothrop procedure in the treatment of complicated chronic frontal sinusitis
P J Wormald1, A Ananda, S Nair
1Department of Surgery - Otolaryngology Head & Neck Surgery, Adelaide and Flinders Universities, South Australia. peterj.wormald@adelaide.edu.au
Abstract:
The purpose of this study was to evaluate the modified endoscopic Lothrop procedure in the management of complicated frontal sinus disease which has breached the confines of the sinus walls and extended into the cranial cavity or orbit. Fourteen patients with radiological evidence of 17 complications of frontal sinus disease presented over a 23-month period. CT scan and MRI scans revealed the presence of posterior table erosion and extension of the frontal sinus disease into the anterior cranial fossa in 10 patients. In addition, seven patients had intraorbital complications, with three patients having both intracranial and orbital complications. All patients underwent a modified endoscopic Lothrop procedure as part of the management of the complication. In addition, one patient required an orbital abscess drainage and repair of an encephalocele, with a second patient requiring drainage of an orbital subperiosteal abscess. At follow-up, all patients were asymptomatic and had patent frontal sinus ostia. Follow-up ranged from 8 months to 38 months with a median of 25 months. Three patients required a revision of their frontal ostium. Two patients had allergic fungal sinusitis with aggressive polyp recurrence and ostial re-stenosis while one patient developed recurrent orbital infections from a retained frontal sinus cell. Currently, all have patent ostia, with an average size of 14.6 x 11 mm. The modified endoscopic Lothrop procedure is an effective form of treatment in the management of complicated frontal sinus disease. The results are comparable to those achieved with other surgical approaches such as the osteoplastic flap with obliteration.
Insights
The modified endoscopic Lothrop procedure effectively manages complicated frontal sinus disease extending into the brain or orbit. This endoscopic approach offers comparable results to traditional open surgeries for complex cases.
Area of Science:
- Otolaryngology
- Neurosurgery
- Ophthalmology
Background:
- Complicated frontal sinus disease involves sinus walls breaching into cranial or orbital spaces.
- Radiological evidence often shows posterior table erosion and intracranial or intraorbital extension.
Purpose of the Study:
- To evaluate the modified endoscopic Lothrop procedure for managing complicated frontal sinus disease.
- To assess the efficacy and outcomes of this minimally invasive technique.
Main Methods:
- Retrospective review of 14 patients with complicated frontal sinus disease over 23 months.
- All patients underwent the modified endoscopic Lothrop procedure.
- CT and MRI scans were used for diagnosis and follow-up.
Main Results:
- All 14 patients were asymptomatic post-procedure with patent frontal sinus ostia.
- Follow-up ranged from 8 to 38 months (median 25 months).
- Three patients required ostium revision, two for fungal sinusitis and one for recurrent orbital infections.
Conclusions:
- The modified endoscopic Lothrop procedure is an effective treatment for complicated frontal sinus disease.
- Outcomes are comparable to the osteoplastic flap with obliteration.
- The technique provides a viable endoscopic alternative for complex sinus pathology.