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.

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 Implication of osteoplastic flap for frontal sinus surgery in the endoscopic era

2019 ◽  
Vol 5 (6) ◽  
pp. 1717
Author(s):  
Aishwarya Raj Pillai Devaraj ◽  
Kothegala Chandrashekariah Prasad ◽  
Abhilasha Karunasagar ◽  
Manna Jose Pappanacherry ◽  
Harshitha Naganna Gowda ◽  
...  
Keyword(s):  
Frontal Sinus ◽  
Traffic Accident ◽  
Road Traffic ◽  
Nasal Bone ◽  
Case Series ◽  
Anterior Wall ◽  
Sinus Surgery ◽  
Sinus Disease ◽  
Good Cosmesis

<p class="abstract">In the present era where functional endoscopic sinus surgery is the mainstay of management for any frontal sinus disease, we present a case series comprising six cases of various frontal sinus pathology that were managed with an external approach using a bicoronal osteoplastic flap technique of which three cases were of inverted papilloma, one case of allergic fungal rhinosinusitis, one case of frontal mucocele and a case of road traffic accident with frontal bone and nasal bone fracture. The cases had a mean follow-up period of 6 months. There was no recurrence of disease and no significant postoperative complications have been reported during the follow-up period so far. Osteoplastic anterior wall approach to the frontal sinus has proved to be one of the most effective, simple, and reliable procedures with excellent success rate and good cosmesis.</p>

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.

scholarly journals Recurrent contracted sockets treated with personalized, three-dimensionally printed conformers and buccal grafts

2021 ◽  
pp. 112067212110000
Author(s):  
Annabel LW Groot ◽  
Jelmer S Remmers ◽  
Roel JHM Kloos ◽  
Peerooz Saeed ◽  
Dyonne T Hartong
Keyword(s):  
Three Dimensional ◽  
Case Series ◽  
Secondary Outcome ◽  
Retrospective Case ◽  
Upper Eyelid ◽  
Ocular Prosthesis ◽  
Buccal Mucosal Graft ◽  
Custom Made ◽  
3D Printed

Purpose: Recurrent contracted sockets are complex situations where previous surgeries have failed, disabling the wear of an ocular prosthesis. A combined method of surgery and long-term fixation using custom-made, three-dimensional (3D) printed conformers is evaluated. Methods: Retrospective case series of nine patients with recurrent excessive socket contraction and inability to wear a prosthesis, caused by chemical burns ( n = 3), fireworks ( n = 3), trauma ( n = 2) and enucleation and radiotherapy at childhood due to optic nerve glioma ( n = 1) with three average previous socket surgeries (range 2–6). Treatment consisted of a buccal mucosal graft and personalized 3D-printed conformer designed to be fixated to the periosteum and tarsal plates for minimal 2 months. Primary outcome was the retention of an ocular prosthesis. Secondary outcome was the need for additional surgeries. Results: Outcomes were measured at final follow-up between 7 and 36 months postoperatively (mean 20 months). Eight cases were able to wear an ocular prosthesis after 2 months. Three cases initially treated for only the upper or only the lower fornix needed subsequent surgery for the opposite fornix for functional reasons. Two cases had later surgery for cosmetic improvement of upper eyelid position. Despite pre-existing lid abnormalities (scar, entropion, lash deficiency), cosmetic outcome was judged highly acceptable in six cases because of symmetric contour and volume, and reasonably acceptable in the remaining two. Conclusions: Buccal mucosal transplant fixated with a personalized 3D-designed conformer enables retention of a well-fitted ocular prosthesis in previously failed socket surgeries. Initial treatment of both upper and lower fornices is recommended to avoid subsequent surgeries for functional reasons.

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.

scholarly journals Draf III frontal sinus surgery for the treatment of Pott’s puffy tumour in adults: our case series and a review of frontal sinus anatomy risk factors

2020 ◽  
Vol 277 (8) ◽  
pp. 2271-2278
Author(s):  
Alfonso Luca Pendolino ◽  
Foteini Stefania Koumpa ◽  
Henry Zhang ◽  
Samuel C. Leong ◽  
Peter J. Andrews
Keyword(s):  
Risk Factors ◽  
Frontal Sinus ◽  
Case Series ◽  
Sinus Surgery ◽  
Frontal Sinus Surgery ◽  
Draf Iii

Bony nasolacrimal duct dehiscence in functional endoscopic sinus surgery: radiological study and discussion of surgical implications

2015 ◽  
Vol 129 (S3) ◽  
pp. S35-S40 ◽  
Author(s):  
M J Ali ◽  
J Murphy ◽  
P J Wormald ◽  
A J Psaltis
Keyword(s):  
Computed Tomography ◽  
Endoscopic Sinus Surgery ◽  
Case Series ◽  
Nasolacrimal Duct ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Retrospective Case ◽  
Computed Tomography Images ◽  
Before And After ◽  
Surgically Induced

AbstractObjectives:To analyse the radiological features of the bony nasolacrimal duct before and after functional endoscopic sinus surgery, and document the incidence of surgically induced dehiscence.Methods:A retrospective case series analysis was conducted of 63 consecutive patients who underwent uncinectomy as a part of 118 functional endoscopic sinus surgical procedures. All patients underwent pre- and post-operative computed tomography scans. Axial computed tomography images at the level of maxillary sinus were evaluated for the presence of bony nasolacrimal duct dehiscence, osteitis and completeness of uncinectomy.Results:The rate of nasolacrimal duct dehiscence prior to surgery was 6.8 per cent (8 out of 118 cases). Nasolacrimal duct dehiscence as a consequence of surgery was observed in 3.3 per cent of cases (4 out of 118), with a further 4.2 per cent (5 out of 118) showing post-operative reactive bony change of the nasolacrimal duct in the absence of dehiscence.Conclusion:The incidence of nasolacrimal duct injury observed was much lower than that previously reported in the literature.

scholarly journals The Bifurcated Frontal Sinus

OTO Open ◽  
2018 ◽  
Vol 2 (1) ◽  
pp. 2473974X1876487
Author(s):  
Edward D. McCoul ◽  
Kiranya E. Tipirneni
Keyword(s):  
Frontal Sinus ◽  
Residual Disease ◽  
Case Series ◽  
Outflow Tract ◽  
Sinus Surgery ◽  
Consecutive Series ◽  
Endoscopic Techniques ◽  
Common Wall ◽  
Computed Tomography Scans ◽  
Extent Of Surgery

Objectives Frontal sinus anatomy is complex, and multiple variations of ethmoid pneumatization have been described that affect the frontal outflow tract. In addition, the lumen proper of the frontal sinus may exist as 2 separate parallel cavities that share an ipsilateral outflow tract. This variant has not been previously described and may have implications for surgical management. Study Design Case series. Setting Tertiary rhinology practice. Subjects and Methods Cases with radiographic and intraoperative findings of separate parallel tracts within a unilateral frontal sinus were identified from a consecutive series of 186 patients who underwent endoscopic sinus surgery between May 2015 and July 2016. Data were recorded including sinusitis phenotype, coexisting frontal cells, and extent of surgery. Results Ten patients (5.4%) were identified with computed tomography scans demonstrating bifurcation of the frontal sinus into distinct medial and lateral lumens. All cases were treated with Draf 2a or 2b frontal sinusotomy with partial removal of the common wall to create a unified ipsilateral frontal ostium. Eleven sides had a coexisting ipsilateral agger nasi cell, 7 had a supra-agger cell, 8 had a suprabullar cell, and 1 had a frontal septal cell. There were no significant complications. Conclusion The bifurcated frontal sinus is an anatomic variant that the surgeon should recognize to optimize surgical outcomes. Failure to do so may result in incomplete clearance of the sinus and residual disease. The bifurcated sinus may occur with other types of frontal sinus cells and may be safely treated with endoscopic techniques.

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.

Endoscopic Surgery for Frontal and Ethmoid Sinus Mucoceles

1994 ◽  
Vol 8 (3) ◽  
pp. 107-112 ◽  
Author(s):  
Thomas L. Kennedy
Keyword(s):  
Endoscopic Surgery ◽  
Endoscopic Sinus Surgery ◽  
Frontal Sinus ◽  
Ethmoid Sinus ◽  
Endoscopic Approach ◽  
Sinus Surgery ◽  
Difficult Cases

Seven patients with frontal and ethmoid mucoceles treated by endoscopic sinus surgery were reviewed. Five cases were successfully managed, with two requiring a trephine procedure in combination with the intranasal endoscopic approach. Follow-up ranged from 3 to 33 months with a mean of 17.8 months. The use of endoscopic instruments through a trephine incision is recommended in difficult cases to assure patency of the frontal sinus recess. When a large frontal sinus mucocele extends into the anterior ethmoid, the endoscopic approach becomes ideal. Sinus mucoceles can be handled safely and successfully by endoscopic surgery and may eliminate the need for more traditional external procedures.

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