The frontal osteoplastic flap: does it still have a place in rhinological surgery?

2010 ◽  
Vol 125 (2) ◽  
pp. 162-168 ◽  
Author(s):  
A Y Isa ◽  
J Mennie ◽  
G W McGarry
Keyword(s):  
Frontal Sinus ◽  
Sinus Surgery ◽  
Royal Infirmary ◽  
Retrospective Case ◽  
Sinus Disease ◽  
Flap Procedure ◽  
Technical Modifications ◽  
Minimal Complication ◽  
Age Range ◽  
Case Note Review

AbstractObjective:To review outcomes and complications in a series of adults undergoing a frontal osteoplastic flap procedure without obliteration, for endoscopically inaccessible sinus disease.Material and method:Retrospective case note review of patients treated at Glasgow Royal Infirmary between January 2004 and October 2008.Results:Ten patients were identified (age range 19–81 years, mean age 46.3 years). No major intra- or post-operative complications occurred. There were three minor complications: superficial discharging wound, forehead swelling and haematoma.Conclusion:The frontal osteoplastic flap still has a role in frontal sinus surgery. With minor technical modifications, this procedure may be performed with minimal complication and morbidity for patients with endoscopically inaccessible frontal sinus disease.

Frontal Sinus Osteoma: Complete Removal via Endoscopic Sinus Surgery and Frontal Sinus Trephination

1992 ◽  
Vol 6 (4) ◽  
pp. 139-143 ◽  
Author(s):  
Richard F. Busch
Keyword(s):  
Surgical Treatment ◽  
Endoscopic Sinus Surgery ◽  
Frontal Sinus ◽  
Complete Removal ◽  
Sinus Surgery ◽  
Sinus Disease ◽  
Less Invasive ◽  
Normal Sinus ◽  
Flap Procedure

Endoscopic sinus surgery has improved our understanding of normal sinus physiology and enabled us to provide better surgical treatment of sinus disease. A method for removal of frontal sinus osteomas was sought that would be less invasive and more physiologic than the conventional osteoplastic flap procedure. Endoscopic sinus surgery has been combined with conventional frontal sinus trephination to achieve total osteoma removal while maintaining normal sinus mucociliary flow. Two successive patients have been treated in this manner with gratifying results.

Combined Lid Crease and Endoscopic Approach to Lateral Frontal Sinus Disease With Orbital Extension

2018 ◽  
Vol 127 (9) ◽  
pp. 637-642 ◽  
Author(s):  
Chadi A. Makary ◽  
Alex Limjuco ◽  
John Nguyen ◽  
Hassan H Ramadan
Keyword(s):  
Frontal Sinus ◽  
Acute Infection ◽  
Case Series ◽  
Endoscopic Approach ◽  
Sinus Surgery ◽  
Lateral Sinus ◽  
Retrospective Case ◽  
Upper Eyelid ◽  
Sinus Disease ◽  
Special Circumstances

Introduction: Functional endoscopic sinus surgery for frontal sinus disease has obviated the need for external approaches. Special circumstances such as acute infection with orbital involvement or significant lateral sinus disease frequently require adjunct access. We describe the clinical outcomes of a combined upper eyelid crease and endoscopic approach for lateral frontal sinus disease with orbital extension. Methods: A retrospective case series of 7 patients who underwent a combined lid crease approach for frontal sinus disease with orbital extension between April 2012 and October 2016 was performed. All patients had the presence of lateral frontal sinus disease as well as orbital extension as seen on a preoperative computed tomography (CT) scan. Patient demographics, indications for surgery, and perioperative findings were examined. Results: Six of the 7 patients were male. Mean age was 61 years, and the indication for surgery was primarily drainage of mucopyocele and inverting papilloma (IP) in 1 patient. The frontal sinus and orbit were successfully accessed, and the respective pathology was addressed in both locations. No intraoperative or postoperative complications were encountered. There was no postoperative or cosmetic complications. Conclusion: The combined lid crease and endoscopic approach is a safe and effective technique for accessing the lateral frontal sinus and orbit.

Role of the Agger Nasi Cell in Chronic Frontal Sinusitis

1996 ◽  
Vol 105 (9) ◽  
pp. 694-700 ◽  
Author(s):  
Joseph B. Jacobs ◽  
Barry A. Shpizner ◽  
Eugenie Brunner ◽  
Richard A. Lebowitz ◽  
Roy A. Holliday
Keyword(s):  
Frontal Sinus ◽  
Clinical History ◽  
Sinus Surgery ◽  
Frontal Sinusitis ◽  
Sinus Disease ◽  
Computed Tomographic ◽  
Mucosal Disease ◽  
Region Data ◽  
History Of

Agger nasi cells contribute to nasofrontal duct (NFD) obstruction and chronic frontal sinus disease. To investigate this relationship, we conducted a review of the surgical outcome and computed tomographic imaging in 26 patients with chronic frontal sinusitis. Coronal and sagittal images were used to delineate the anatomic variability and mucosal disease in the NFD and frontal sinus region. Data from coronal and sagittal images were compared. The results were also correlated with the outcome of frontal sinus surgery in patients with a clinical history of chronic frontal sinus disease. Our data suggest that agger nasi cell pneumatization with narrowing of the frontal sinus outflow tract is a significant cause of persistent frontoethmoid pain and chronic frontal sinusitis. Sagittal reformatted images are more capable than coronal images of demonstrating agger nasi cell encroachment on the NFD, as well as NFD mucosal disease. Endoscopic frontal sinusotomy is an effective treatment for chronic frontal sinus disease.

Long-term stenting for chronic frontal sinus disease: case series and literature review

2010 ◽  
Vol 124 (11) ◽  
pp. 1216-1222 ◽  
Author(s):  
B Hunter ◽  
S Silva ◽  
R Youngs ◽  
A Saeed ◽  
V Varadarajan
Keyword(s):  
Frontal Sinus ◽  
Relevant Literature ◽  
Case Series ◽  
Outflow Tract ◽  
Sinus Surgery ◽  
Sinus Disease ◽  
Narrow Channels ◽  
Co Morbidity ◽  
Disease Case

AbstractObjective:The frontal sinus outflow tract consists anatomically of narrow channels prone to stenosis. Following both endonasal and external approach surgery, up to 30 per cent of patients suffer post-operative re-stenosis of the frontal sinus outflow tract, with recurrent frontal sinus disease. This paper proposes the surgical placement of a long-term frontal sinus stent to maintain fronto-nasal patency, as an alternative to more aggressive surgical procedures such as frontal sinus obliteration and modified Lothrop procedures.Design:We present a series of three patients with frontal sinus disease and significant co-morbidity, the latter making extensive surgery a significant health risk. We also review the relevant literature and discuss the use of long-term frontal sinus stenting.Results:These three cases were successfully treated with long-term frontal sinus stenting. Stents remained in situ for a period ranging from 48 to over 60 months.Conclusion:Due to the relatively high failure rates for both endonasal and external frontal sinus surgery, with a high post-operative incidence of frontal sinus outflow tract re-stenosis, long-term stenting is a useful option in carefully selected patients.

scholarly journals Role of Osteoplastic Frontal Sinus Obliteration in the Era of Endoscopic Sinus Surgery

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Joshua B. Silverman ◽  
Stacey T. Gray ◽  
Nicolas Y. Busaba
Keyword(s):  
Frontal Sinus ◽  
Tertiary Care ◽  
Sinus Surgery ◽  
Salvage Procedure ◽  
Frontal Sinusitis ◽  
First Line ◽  
Total Study Population ◽  
Sinus Disease ◽  
History Of ◽  
Sinus Obliteration

Objective. Determining the indications for osteoplastic frontal sinus obliteration (OFSO) for the treatment of inflammatory frontal sinus disease.Study Design. Retrospective case series from a single tertiary care facility.Methods. Thirty-four patients who underwent OFSO for chronic frontal sinusitis () and frontal sinus mucocele () comprised our study group. Data reviewed included demographics, history of prior frontal sinus operation(s), imaging, diagnosis, and operative complications.Results. The age range was 19 to 76 years. Seventy percent of patients with chronic frontal sinusitis underwent OFSO as a salvage surgery after previous frontal sinus surgery failures, while 30% underwent OFSO as a primary surgery. For those in whom OFSO was a salvage procedure, the failed surgeries were endoscopic approaches to the frontal sinus (69%), Lynch procedure (12%), and OFSO outside this study period (19%). For patients with frontal sinus mucocele, 72% had OFSO as a first-line surgery. Within the total study population, 15% of patients presented for OFSO with history of prior obliteration, with a range of 3 to 30 years between representations.Conclusions. Osteoplastic frontal sinus obliteration remains a key surgical treatment for chronic inflammatory frontal sinus disease both as a salvage procedure and first-line surgical therapy.

scholarly journals Karydakis Flap Procedure in Patients with Sacrococcygeal Pilonidal Sinus Disease: Experience of a Single Centre in Istanbul

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
M. Kamil Yildiz ◽  
Erkan Ozkan ◽  
Hacı Mehmet Odabaşı ◽  
Bülent Kaya ◽  
Cengiz Eriş ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Pilonidal Sinus ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Sinus Surgery ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Satisfaction Rate ◽  
Flap Procedure ◽  
The Mean

Background. The aim of this retrospective study was to evaluate the results of patients with sacrococcygeal pilonidal sinus who underwent surgery using the Karydakis technique.Methods. Two hundred fifty-seven patients with sacrococcygeal pilonidal sinus disease were treated by the Karydakis flap procedure between December 2003 and June 2011. Patients were evaluated with respect to age, gender, preoperative symptoms, duration of preoperative symptoms, history of pilonidal sinus surgery, early postoperative complications, recurrence rates, and cosmetic satisfaction.Results. There were 223 (86.8%) male and 34 (13.2%) female patients. The mean age of the patients was years. The most frequent symptom was seropurulent discharge (57.58%). Postoperative morbidity was noted in 24 patients (9.3%). The mean hospital length of stay was days. The cosmetic satisfaction rate was 91.06%. Recurrences were noted in 6 patients (2.3%).Conclusion. The Karydakis flap procedure is a safe treatment alternative for the surgical treatment of sacrococcygeal pilonidal sinus disease owing to the associated low complication rate, short hospital length of stay, rapid healing, and a high patient satisfaction rate.

Frontal Sinus Surgery: The State of the Art

2016 ◽  
Vol 7 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Michael J Marino ◽  
Edward D McCoul
Keyword(s):  
Outcomes Research ◽  
Frontal Sinus ◽  
State Of The Art ◽  
The State ◽  
Sinus Surgery ◽  
Indications For Surgery ◽  
Ongoing Research ◽  
Sinus Disease ◽  
Frontal Sinus Surgery ◽  
Essential Components

ABSTRACT Aim: Review and describe the essential components of modern frontal sinus surgery. Background Frontal sinus surgery has evolved considerably over the last century, and advances in imaging, optics, and instrumentation have contributed to contemporary treatment paradigms. Outcomes assessment has had an important role in identifying indications for surgery and future areas of research. Review results Numerous advancements are part of modern frontal sinus surgery and the treatment of frontal sinusitis. Anatomic studies have revealed variations that are associated with disease and pose challenges for surgery. Open approaches remain relevant in situations of difficult disease or as part of combined approaches. Endoscopic surgery, however, is central to contemporary surgical management of frontal sinus disease. Evolving instrumentation and the development of new implantable devices are increasingly relevant in the endoscopic era. Outcomes research has refined indications for surgery and identifies areas for ongoing research. Conclusion State-of-the-art frontal sinus surgery is the product of significant evolution and advancement. Modern surgery is reflective of improved optics and new instrumentation, and the central role of endoscopic approaches in treating frontal sinus disease. Outcomes research has been essential for developing an evidenced-based approach to frontal sinus surgery. Clinical significance A review of the essential components of state-of-the-art frontal sinus surgery for the practicing otolaryngologist. How to cite this article Marino MJ, McCoul ED. Frontal Sinus Surgery: The State of the Art. Int J Head Neck Surg 2016;7(1): 5-12.

scholarly journals In-office Balloon Dilation and Drainage of Frontal Sinus Mucocele

2013 ◽  
Vol 4 (1) ◽  
pp. ar.2013.4.0041 ◽  
Author(s):  
Jean Anderson Eloy ◽  
Pratik A. Shukla ◽  
Osamah J. Choudhry ◽  
Jean Daniel Eloy ◽  
Paul D. Langer
Keyword(s):  
Patient Satisfaction ◽  
Operating Room ◽  
Endoscopic Sinus Surgery ◽  
Frontal Sinus ◽  
Balloon Dilation ◽  
Sinus Surgery ◽  
Surgical Drainage ◽  
Sinus Disease ◽  
The Past ◽  
Office Procedures

Treatment of frontal sinus disease represents one of the most challenging aspects of endoscopic sinus surgery. Frontal sinus mucocele drainage may be an exception to the rule because in many instances, the expansion of the mucocele widens the frontal sinus recess and renders surgical drainage technically undemanding. Recently, there has been an increased interest in in-office procedures in otolaryngology because of patient satisfaction and substantial savings of time and cost for both patients and physicians. Similarly, the past few years have witnessed an increased use of balloon dilation devices in sinus surgery. Previously, we have described the in-office use of this device in treating patients who failed prior conventional frontal sinusotomy in the operating room. In this report, we describe our step-by-step in-office experience using this tool for drainage of a large frontal sinus mucocele.

Intracranial complications of sinusitis: the need for aggressive management

1995 ◽  
Vol 109 (11) ◽  
pp. 1061-1062 ◽  
Author(s):  
R. L. Jones ◽  
N. S. Violaris ◽  
S. V. Chavda ◽  
A. L. Pahor
Keyword(s):  
Early Diagnosis ◽  
Burr Hole ◽  
Sinus Surgery ◽  
Aggressive Treatment ◽  
Sinus Disease ◽  
Aggressive Management ◽  
Streptococcus Milleri ◽  
Intracranial Complications ◽  
High Index Of Suspicion ◽  
Age Range

AbstractSinus-induced intracranial sepsis can represent a genuine medical and surgical emergency. We review 12 cases presenting to our hospitals over a five-year period. Nine were male and three were female with an age range of 16 to 74 years (mean 35.5 years). Four patients had their sinusitis diagnosed prior to admission and eight did not. Nine patients had bilateral sinus disease, the most common sinus involved was the frontal followed by the ethmoid, maxillary and sphenoid. Neurosurgical drainage was via a craniotomy in seven cases and burr hole in three. Nine patients underwent sinus surgery and three did not. Of the nine who had sinus surgery three had frontal drainage, four fronto-ethmoidal and two transsphenoidal drainage. The most common organism was Streptococcus milleri. Our series confirms that sinus-induced intracranial sepsis is a serious problem needing early diagnosis and aggressive treatment. We would recommend a high index of suspicion of sinusitis in patients with intracranial infection.

scholarly journals Utility of Intraoperative Flexible Endoscopy in Frontal Sinus Surgery

2017 ◽  
Vol 8 (2) ◽  
pp. ar.2017.8.0205 ◽  
Author(s):  
Eric T. Carniol ◽  
Alejandro Vázquez ◽  
Tapan D. Patel ◽  
James K. Liu ◽  
Jean Anderson Eloy
Keyword(s):  
Surgical Management ◽  
Frontal Sinus ◽  
Surgical Techniques ◽  
Disease Process ◽  
Flexible Endoscopy ◽  
Sinus Surgery ◽  
Sinus Disease ◽  
Frontal Sinus Surgery ◽  
Far Lateral ◽  
Draf Iii

Background Surgical management of the frontal sinus can be challenging. Extensive frontal sinus pneumatization may form a far lateral or supraorbital recess that can be difficult to reach by conventional endoscopic surgical techniques, requiring extended approaches such as the Draf III (or endoscopic modified Lothrop) procedure. Rigid endoscopes may not allow visualization of these lateral limits to ensure full evacuation of the disease process. Methods Here we describe the utility of intraoperative flexible endoscopy in two patients with far lateral frontal sinus disease. Results In both cases, flexible endoscopy allowed confirmation of complete evacuation of pathologic material, thereby obviating more extensive surgical dissection. Conclusion In cases where visualization of the far lateral frontal sinus is inadequate with rigid endoscopes, flexible endoscopy can be used to determine the need for more extensive dissection.

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