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Updated: Jun 21, 2026
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Where endoscopy fails: indications and experience with the frontal sinus fat obliteration
Michael B Soyka1, Alexandra Annen, David Holzmann
1Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland.
Background:
With the event of angled endoscopes, image guidance and the rapidly improving endoscopic techniques the previously used osteoplastic frontal sinus fat obliteration (ISO) becomes more and more a second line treatment option. The objective of our study is to describe the up-to-date indications for FSO based on our own experience.
Methods:
Retrospective analysis including follow-up visits of 77 patients with frontal sinus fat obliteration at our clinic between 1991 and 2006 was undertaken and descriptive statistics were drawn.
Results:
Thirty-six cases were operated by FSO as a first-line treatment, 41 had previous surgery. Eighty percent of all patients showed no postoperative residual complaints. Two patients required revision surgery. General complication rate was 36.4%, however these consisted in the vast majority of cases (90%) of minor complications.
Conclusions:
FSO still remains a valuable operation for specific indications. FSO is the gold standard for repeatedly failed endoscopic procedures. The operation should also target the following indications as a first-line treatment: large/lateral osteomas, malignant disease, lateral mucoeceles, most fractures of the posterior sinus wall with CSF-leak, osteomyelitis, pathologies in small underdeveloped sinuses with narrow floor. It is associated with minimal complications and a good outcome.
