[Endoscopic management of chronic frontal sinusitis in the Negev population, Israel]

Chronic frontal sinusitis is a relatively common condition, yet one with potential for complications. The treatment of chronic frontal sinusitis has always been a challenge for the otolaryngologist, and it remains so even in the age of endoscopic sinus surgery. Successful treatment is evaluated by both subjective (patient history) and objective (radiologic and endoscopic) criteria.

This article aims to present our experience in endoscopic surgery for chronic frontal sinusitis, with particular focus on the importance of the wide opening of the naso-frontal outflow tract, with maximal preservation of the mucosa in this area.

During the period 1999 to 2001, 72 patients at the Soroka University Medical Center underwent endoscopic surgery for chronic frontal sinusitis. We reviewed the cases of fifty four patients of this group with a minimum six months follow-up. Patients who did not return for routine post-operative visits were excluded from this study. We evaluated and quantified subjective measurements including facial pain, nasal respiratory obstruction and hyposmia, and objective measurements, based on radiographic studies and endoscopic examination.

Most patients experienced improvement in all of the subjective categories, and particularly in the categories of facial pain/headache and nasal respiratory obstruction. Most patients who experienced this improvement had suffered from chronic pansinusitis.

The endoscopic management of chronic frontal sinus disease is an effective treatment, when principles of wide sinus drainage with maximal mucosal preservation are observed. Most patients undergoing this type of procedure experience significant clinical and radiologic improvement in their condition.