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Indications for external frontal sinus procedures for inflammatory sinus disease.
Samuel Hahn1, James N Palmer, Michael T Purkey
1Division of Rhinology, Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
American Journal of Rhinology & Allergy
|June 4, 2009
Summary
External approaches for frontal sinus surgery are often used for neo-osteogenesis, particularly after prior trauma or endoscopic sinus surgery. While effective, these methods have a high revision rate.
Area of Science:
- Otolaryngology
- Rhinology
- Surgical Innovation
Background:
- The role of external approaches in frontal sinus surgery for inflammatory disease remains unclear.
- This study investigates the utilization and outcomes of external approaches in frontal sinus surgery.
Purpose of the Study:
- To characterize patients undergoing external frontal sinus surgery.
- To propose indications for external approaches alone or combined with functional endoscopic sinus surgery (FESS).
Main Methods:
- Retrospective review of frontal sinus procedures for inflammatory disease (2004-2007).
- Analysis of cases involving external approaches, either alone or with FESS.
Main Results:
- 38 (5.3%) of 717 procedures used an external approach (14 alone, 24 with FESS).
- Osteoplastic flap with obliteration was common for neo-osteogenesis; trephination for frontal recess cells or osteomyelitis.
- 74% had prior surgery; 60% of those without prior surgery still required external adjunct for neo-osteogenesis.
Conclusions:
- External approaches are primarily used for neo-osteogenesis of the frontal recess.
- Factors like trauma, prior endoscopic surgery, and osteomyelitis influence neo-osteogenesis.
- External frontal sinus surgery manages inflammatory disease but has a high revision rate.
