Minimally Invasive Endoscopic Sinus Surgery for Frontal Sinus Pathologies Using Interventional Flexible Bronchoscopy:...

Area of Science:

• Otolaryngology
• Minimally Invasive Surgery
• Rhinology

Background:

• Lateral frontal sinus pathologies present challenges for conventional endoscopic sinus surgery (ESS).
• Rigid endoscopes and instruments limit visualization and access to these difficult-to-treat areas.
• Extended endoscopic or external approaches are often necessary for lateral frontal sinus conditions.

Purpose of the Study:

• To evaluate the utility of interventional flexible bronchoscopy in frontal endoscopic sinus surgery (ESS).
• To demonstrate the effectiveness of flexible bronchoscopy in treating lateral frontal sinus pathologies without extended approaches.

Main Methods:

• Interventional flexible bronchoscopy was employed in two cases of frontal sinus pathology.
• Case 1: Fungus ball in the frontal sinus with a frontoethmoidal cell.
• Case 2: Revision surgery for an obstructing frontoethmoidal cell.

Main Results:

• Flexible bronchoscopy enabled comprehensive treatment of frontal sinus recesses and frontoethmoidal cell opening (Draf IIa).
• Successful revision surgery was achieved using the flexible bronchoscopy technique.
• Patients experienced no complications, with symptom recurrence absent at 4 and 15 months post-procedure.

Conclusions:

• Flexible bronchoscopy provides excellent visualization and therapeutic capabilities for lateral frontal sinus pathologies.
• This technique facilitates treatment through limited endoscopic approaches, including resection of frontoethmoidal cells via through-the-scope instruments.