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Modified osteoplastic flap approach for frontal sinus disease.
Mohannad Al-Qudah1, Scott M Graham
1Division of Rhinology, Department of Otolaryngology--Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA.
Osteoplastic flap surgery remains a safe and effective option for complex frontal sinus disease, even with the rise of endoscopic techniques. This procedure is particularly useful for laterally located issues and skull base defects.
Area of Science:
- Otolaryngology
- Neurosurgery
- Plastic Surgery
Background:
- Endoscopic sinus surgery is now the standard for most frontal sinus disease.
- Osteoplastic flap surgery (OPS) is less common but still relevant for complex cases.
Purpose of the Study:
- To review the use and outcomes of osteoplastic flap surgery.
- To evaluate its safety and efficacy in the current endoscopic era.
Main Methods:
- Retrospective review of 312 sinus surgeries for frontal sinus disease.
- Analysis of 17 patients who underwent osteoplastic flap surgery between 2002 and 2008.
Main Results:
- Indications included mucoceles (8), tumors (7), and osteomyelitis (2).
- 10 patients had skull base erosion; 5 underwent cranialization.
- Average blood loss was 175 mL, hospital stay 3 days, with no major complications.
- Two patients with mucoceles required revision surgery.
Conclusions:
- Osteoplastic flap surgery is uncommon but safe and effective for complex frontal sinus disorders.
- It is particularly indicated for laterally located disease and skull base defects.
- The procedure offers a viable solution for recalcitrant frontal sinus conditions.
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