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Comprehensive access strategies to the frontal sinus
Mario Turri-Zanoni1,2, Paolo Battaglia1,2, Maurizio Bignami1,2
1Division of Otorhinolaryngology.
Current Opinion in Otolaryngology & Head and Neck Surgery
|November 28, 2022
Summary
Frontal sinus surgery offers various endoscopic endonasal and external approaches. Selecting the best surgical strategy based on patient anatomy and disease is crucial for successful outcomes.
Area of Science:
- Otolaryngology
- Neurosurgery
- Endoscopic Surgery
Background:
- The frontal sinus presents surgical challenges despite advancements in endoscopic techniques.
- Choosing the optimal surgical approach requires careful consideration of patient anatomy and disease pathology.
Approach:
- Review of minimally invasive endonasal approaches (e.g., balloon dilatation, Draf I).
- Analysis of extended endonasal techniques (e.g., Draf IIA-IIC, Draf III, orbital transposition).
- Evaluation of traditional external procedures (e.g., osteoplastic flap, Riedel procedure) and combined methods.
Key Points:
- Endoscopic endonasal techniques have significantly expanded surgical options for frontal sinus diseases.
- External procedures remain essential for cases unsuitable for endonasal surgery.
- Careful case selection is paramount for achieving successful surgical outcomes.
Conclusions:
- Endoscopic advancements offer less invasive options for frontal sinus management.
- External approaches are indicated for select cases not amenable to endoscopic techniques.
- Tailoring the surgical strategy to individual patient factors ensures optimal results.
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