Modified hemi-Lothrop procedure for supraorbital frontal sinus access: a cadaveric feasibility study

Area of Science:

• Otolaryngology
• Endoscopic Sinus Surgery
• Neurosurgery

Background:

• The endoscopic modified Lothrop procedure (EMLP) is an advanced technique for recalcitrant frontal sinus disease.
• Limited data exists for advanced, unilateral, supraorbital frontal sinus disease.
• A novel modification, the modified hemi-Lothrop procedure (MHLP), is proposed.

Purpose of the Study:

• To describe and demonstrate the modified hemi-Lothrop procedure (MHLP).
• To assess the MHLP's feasibility and accessibility for unilateral frontal sinus disease.
• To evaluate MHLP's potential to spare contralateral frontal sinus mucosa and drainage pathways.

Main Methods:

• Cadaveric dissection with photodocumentation.
• Demonstration of the MHLP technique via a superior septectomy window.
• Quantification of access to far-laterally based frontal sinus disease.

Main Results:

• The MHLP provided adequate access to distal supraorbital and lateral frontal sinus aspects.
• The technique was successfully demonstrated on three cadavers.
• MHLP allows access from the contralateral nasal cavity.

Conclusions:

• The MHLP is a feasible endoscopic alternative for unilateral frontal sinus disease.
• This modification may address difficult-to-access unilateral disease requiring less extensive resection.
• MHLP defines lateral frontal sinus accessibility and identifies potential patient candidates.