Use of a New Mucoperiosteal Flap from the Upper Lateral Nasal Wall in Frontal Sinus Surgery

Various mucoperiosteal flaps from the nose (nasal walls) are in use today in frontal sinus surgery in cases where a wide opening between the frontal sinus and the nasal cavity is created. These flaps are transferred to cover denuded bone in the area of opening and thus prevent the opening from narrowing or closing, which would result in the reappearance of frontal sinus problems. In this paper, a new mucoperiosteal flap taken from the upper extension of middle turbinate is described.

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Virtual Mapping of the Frontal Recess: Guiding Safe and Efficient Frontal Sinus Surgery

Otolaryngology ◽

10.1177/0194599817699562 ◽

2017 ◽

Vol 156 (5) ◽

pp. 946-951 ◽

Cited By ~ 4

Author(s):

Neil S. Patel ◽

Amy C. Dearking ◽

Erin K. O’Brien ◽

John F. Pallanch

Keyword(s):

Frontal Sinus ◽

Tertiary Care ◽

Middle Turbinate ◽

Uncinate Process ◽

Sinus Surgery ◽

Preoperative Imaging ◽

Level Of Evidence ◽

Frontal Recess ◽

Frontal Sinus Surgery ◽

Sinus Opening

Objective To define relationships between the frontal sinus opening, ostia of other frontal recess cells, and endoscopic landmarks and to develop a clinically useful framework to guide frontal sinus surgery. Study Design Retrospective review. Setting Tertiary care academic referral center. Methods Adult patients with computed tomography (CT) without sinonasal pathology were included. Virtual endoscopy (using OsiriX) and corresponding CT reconstructions were used to identify all visible ostia in the frontal recess and characterize their positions in spaces between the uncinate/agger nasi (U), bulla ethmoidalis (EB), and middle turbinate (MT). Results Two hundred sides in 100 patients (median age 51 years, 62% female) were analyzed. The “center” of each map was defined as the intersection of spaces between U, EB, and MT. The frontal sinus opening was in the “center” in 53% of frontal recesses, lateral to this position in 29%, and anterior in 11%. When the frontal sinus opening was at the “center,” anterior ostia drained frontal Kuhn T cells in 51% and intersinus septal cells in 23%. The skull base attachment of the apical strut of the uncinate process demarcated medial and lateral within the space between U and EB, with the opening to the frontal sinus medial in 68% and lateral in 31%. Left-right asymmetry in frontal sinus openings was noted in 46% of patients. Conclusion Combining preoperative imaging and knowledge of these anatomic relationships may facilitate more efficient frontal outflow tract identification and instrumentation. This represents the first and largest description of ostial configurations relative to endoscopic structural landmarks. Level of Evidence: 4

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THE MUCOPERIOSTEAL FLAP IN FRONTAL SINUS SURGERY

The Laryngoscope ◽

10.1288/00005537-197308000-00011 ◽

1973 ◽

Vol 83 (8) ◽

pp. 1266-1280 ◽

Cited By ~ 27

Author(s):

Shirley H. Baron ◽

Herbert H. Dedo ◽

Charles R. Henry

Keyword(s):

Frontal Sinus ◽

Sinus Surgery ◽

Frontal Sinus Surgery ◽

Mucoperiosteal Flap

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Frontal Sinus Surgery Anterior to the Ethmoid Bulla

International Surgery ◽

10.9738/cc37 ◽

2013 ◽

Vol 98 (2) ◽

pp. 149-155 ◽

Cited By ~ 2

Author(s):

Junfeng Ji ◽

Mei Zhou ◽

Zeqing Li ◽

Tianyou Wang ◽

You Cheng ◽

...

Keyword(s):

Frontal Sinus ◽

Middle Turbinate ◽

Sinus Surgery ◽

Frontal Sinus Surgery ◽

Relative Constant ◽

Anterior Ethmoid Artery

Abstract The frontal sinus surgery is difficult to perform but the ethmoid bulla is a relative, constant landmark in the middle turbinate that can improve the surgery. The purpose of this study was to evaluate the validity, security, and predominance of approaches to the frontal sinus via the route anterior to the ethmoid bulla. The data from 370 endoscopic frontal sinus surgery cases from our center were integrated and retrospectively analyzed. Three hundred twenty-nine patients underwent frontal sinus surgery via the route anterior to the ethmoid bulla. An additional 27 patients underwent frontal sinus surgery with mini-trephination, 13 patients with the Draf II procedure, and 1 patient had applied MELP (modified endoscopic Lothrop procedure). No serious complications occurred; however, there were 3 cases of eyelid ecchymosis and 1 case of anterior ethmoid artery bleeding. In all, 319 patients (86.2%) were cured, an improvement was noted in 36 of the patients (9.7%), and there was no improvement in 15 patients (4.1%). Frontal sinus surgery via the route anterior to the ethmoid bulla is valid, relatively safe, and can be applied in most cases involving frontal disease.

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A Newly Designed Anterolateral Septal Flap to Preserve the Nasal Cavity or Prevent Restenosis of the Drainage Pathway in Extended Frontal Sinus Surgery

Nihon Bika Gakkai Kaishi (Japanese Journal of Rhinology) ◽

10.7248/jjrhi.56.608 ◽

2017 ◽

Vol 56 (4) ◽

pp. 608-618

Author(s):

Takefumi Mikuriya ◽

Yasuro Shin ◽

Makoto Hashimoto ◽

Hironori Fujii ◽

Hirohito Umeno ◽

...

Keyword(s):

Nasal Cavity ◽

Frontal Sinus ◽

Sinus Surgery ◽

Frontal Sinus Surgery

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Transient Positioning of a Silicone T Tube in Frontal Sinus Surgery

Otolaryngology ◽

10.1177/019459989411100613 ◽

1994 ◽

Vol 111 (6) ◽

pp. 776-780 ◽

Cited By ~ 5

Author(s):

Tatsuya Yamasoba ◽

Shigeru Kikuchi ◽

Ryuzaburo Higo

Keyword(s):

Nasal Cavity ◽

Frontal Sinus ◽

Sinonasal Tract ◽

Sinus Surgery ◽

T Tube ◽

Frontal Sinus Surgery ◽

Persistent Inflammation ◽

Mucosal Lining

We applied transient positioning of a silicone T tube in 18 patients with frontal sinus cysts. Inflammation in the nasal cavity usually subsided within 6 months of surgery, whereas the frontal sinus showed pathologic changes in more than half of the patients even 6 months after surgery. After removal of the tube, the nasofrontal passage remained open in 16 patients who obtained good aeration with an intact mucosal lining in the frontal sinus, but it eventually closed in the remaining 2 patients who failed to obtain good aeration. This finding suggests that persistent inflammation in the frontal sinus encourages the closure of the nasofrontal passage and that transient positioning of a silicone T tube is successful if it is removed after subsidence of inflammation in the sinonasal tract.

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Revision endoscopic frontal sinus surgery for refractory chronic rhinosinusitis via modified agger nasi approach

Journal of International Medical Research ◽

10.1177/0300060521995273 ◽

2021 ◽

Vol 49 (4) ◽

pp. 030006052199527

Author(s):

Jun Dai ◽

De Huai ◽

Min Xu ◽

Jingjing Cai ◽

Haixu Wang

Keyword(s):

Chronic Rhinosinusitis ◽

Frontal Sinus ◽

Middle Turbinate ◽

Sinus Surgery ◽

Control Group ◽

Efficacy Rate ◽

Clinical Effects ◽

Observation Group ◽

Frontal Sinus Surgery ◽

Symptoms And Signs

Objective To examine the clinical effects of revision endoscopic frontal sinus surgery (RESS) through modified agger nasi (MAN)–middle turbinate resection on refractory chronic rhinosinusitis (CRS). Methods We reviewed 156 patients who were treated for refractory CRS from February 2012 to August 2014. These patients had been diagnosed with refractory CRS by computed tomography and endoscopy and had received several surgical and medical treatments in the past, but their condition had not been cured. They were divided into the observation group (RESS through MAN–middle turbinate resection, n = 78) and the control group (endoscopic sinus surgery, n = 78). Complete or partial control of the patient’s symptoms and signs suggested that the treatment was effective, and no improvement in the symptoms and signs indicated that the treatment was ineffective. Results The 6-month treatment efficacy rate was significantly higher in the observation group (91.03%) than in the control group (71.79%). The observation group had a significantly lower complication rate (7.69%) and recurrence rate (3.85%) than the control group (17.95% and 12.82%, respectively). Conclusion RESS through MAN–middle turbinate resection together with adequate perioperative preparation has a significant effect on the outcome of refractory CRS and is worthy of clinical promotion.

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First Olfactory Fiber as an Anatomical Landmark for Frontal Sinus Surgery

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0036-1579951 ◽

2016 ◽

Vol 77 (S 01) ◽

Author(s):

Smita Upadhyay ◽

Lamia Buohliqah ◽

Gerival Junior ◽

Bradley Otto ◽

Daniel Prevedello ◽

...

Keyword(s):

Frontal Sinus ◽

Anatomical Landmark ◽

Sinus Surgery ◽

Frontal Sinus Surgery

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Our Endoscopic Frontal Sinus Surgery Technique: Long Term Results

Türk Rinoloji Dergisi ◽

10.24091/trhin.2009-16540 ◽

2013 ◽

Vol 2 (2) ◽

pp. 59-64

Author(s):

Hasan Murat TANYERİ ◽

Şenol POLAT

Keyword(s):

Frontal Sinus ◽

Sinus Surgery ◽

Long Term Results ◽

Frontal Sinus Surgery ◽

Surgery Technique

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Extended endoscopic frontal nasal sinus surgery in management of chronic and recurrent frontal sinus diseases

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00104-x ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Ahmed Sobhi Abdelaal ◽

Mohamed Kamel Al Awady ◽

Tawfik Abdelaty Elkholy

Keyword(s):

Frontal Sinus ◽

Anatomical Variation ◽

Sinus Surgery ◽

Frontal Sinusitis ◽

Office Visits ◽

Nasal Sinus ◽

Frontal Sinus Surgery ◽

Operative Care ◽

Intimate Relation

Abstract Background The anatomical variation of the frontal sinus and its intimate relation to the skull base and orbit makes its surgery demanding. The extended endoscopic frontal sinus surgery allows wide better drainage and preventing the recurrence of the disease. Fourteen patients underwent EEFSS from May 2017 to May 2019. These patients are nine patients presented by chronic recurrent frontal sinusitis, three patients presented by chronic recurrent fronto ethmoidal mucocele and two patients with chronic recurrent external frontal fistula. Draff III done for ten patients of them and Draff IIB done for four patients of them. This study is designed for evaluating the efficacy of the extended endoscopic frontal sinus surgery (E E F S S) in management of chronic and recurrent frontal sinus diseases. Results The neo opening of the restored frontal sinus was remained opened with Draff III with high success rate; two patients from four patients with Draff IIb were with closed nasofrontal duct. The main follow-up was 12 months; the patients were followed up post-operatively for many office visits without any other manifestations. Conclusion The chronic recurrent frontal sinus diseases can be treated successfully with extended endoscopic frontal sinus surgery (E E F S S). The extended endoscopic frontal sinus surgery (Draff III) provides good results with low morbidity and less post-operative care.

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