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Frontal sinus "mega-trephination" in a tertiary rhinology practice.
Mathew Geltzeiler1, Alia Mowery1, Kara Y Detwiller1
1Oregon Sinus Center, Division of Rhinology & Sinus/Skull Base Surgery, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, OR.
International Forum of Allergy & Rhinology
|August 13, 2019
Summary
Frontal sinus mega-trephination, a technique for endoscopic sinus surgery, is safe and effective for treating various frontal sinus conditions. This procedure does not lead to long-term cosmetic deformities, making it a valuable surgical option.
Area of Science:
- Otolaryngology
- Neurosurgery
- Rhinology
Background:
- Traditional frontal sinus trephination involves a small incision for irrigation.
- Endoscopic visualization requires a larger opening, termed "mega-trephination."
- Mega-trephination may pose risks of cosmetic deformity due to increased bone removal.
Purpose of the Study:
- To assess the risks associated with frontal sinus mega-trephination.
- To evaluate the integration of this technique in a tertiary care rhinology practice.
Main Methods:
- Retrospective chart review of patients undergoing frontal sinus mega-trephination.
- Definition of mega-trephination: osteotomy allowing simultaneous 4-mm endoscope and instrument insertion.
- Minimum follow-up of 2 years, with primary outcome being complication rate, including cosmetic deformity.
Main Results:
- Sixty-four patients underwent the procedure between 2006 and 2016.
- Common indications included chronic sinusitis, mucoceles, and osteomas.
- Minor complications occurred in 33% of patients (paresthesia, infection, epistaxis); no permanent cosmetic deformities or revisions for cosmesis were reported.
Conclusions:
- Frontal sinus mega-trephination is a valuable addition to surgical armamentarium for complex frontal sinus issues.
- The procedure is safe, well-tolerated, and does not result in long-term cosmetic deformities.