scholarly journals Frontal sinus mucocoeles: new algorithm for surgical management

2014 ◽  
Vol 52 (3) ◽  
pp. 267-275
Author(s):  
A. Sama ◽  
L. McClelland ◽  
J. Constable
Keyword(s):  
Surgical Management ◽  
Frontal Sinus ◽  
Treatment Algorithm ◽  
Sinus Surgery ◽  
Retrospective Case ◽  
Sinus Wall ◽  
Novel Method ◽  
Structured Approach ◽  
Classification And Treatment ◽  
Ct And Mri

Background: Frontal sinus mucocoeles require a structured approach to their surgical management. We share our experience of a novel method of positional classification for frontal mucocoele and corresponding surgical algorithm. Methods: A retrospective case-note review examined all frontal sinus surgery for mucocoele, spanning three years (2008-2010). Patients had pre-operative nasendoscopy, multi-planar CT and MRI when indicated. Several important variables (position, drainage dimensions, fronto-ethmoidal cells and degree of neo-osteogenesis) were noted. A systematic algorithm was used for surgical drainage based on these characteristics. The three year outcomes using this approach are presented. Results: Thirty-six patients were identified with a total of 43 frontal mucocoeles. Using our classification, 30 mucocoeles were medial; seven were intermediate; six were lateral. Thirty-four patients underwent a primary endoscopic procedure; six required a combined primary osteoplastic-flap (OPF) and endoscopic approach. Six patients required revision surgery for polypoidal change or neo-ostium stenosis. All patients were eventually rendered asymptomatic. Conclusion: Implementation of our positional classification and surgical algorithm was successful with a revision rate of 19%. Presence of frontal sinus wall dehiscence and extra-sinus mucocoele extension are invalid indicators for external approach. We feel our classification and treatment algorithm, with its associated indicators for surgical escalation (i.e. limited dimensions of frontal ostium, presence of Type III / IV front-ethmoidal cells etc), are applicable for future management of frontal mucocoeles.

Frontal sinus models and onlay templates in osteoplastic flap surgery

2010 ◽  
Vol 125 (1) ◽  
pp. 82-85 ◽  
Author(s):  
M Daniel ◽  
J Watson ◽  
E Hoskison ◽  
A Sama
Keyword(s):  
Frontal Sinus ◽  
Three Dimensional ◽  
Image Data ◽  
Sinus Surgery ◽  
Three Dimensional Printing ◽  
Frontal Sinus Surgery ◽  
Tomography Image ◽  
Novel Method ◽  
Computed Tomography Image ◽  
Dimensional Printing

AbstractObjective:Precise delineation of the extent of frontal sinus pneumatisation is a crucial step in osteoplastic flap frontal sinus surgery. The authors present a novel method of achieving this objective.Methods:First, models of the frontal area are generated using three-dimensional printing based on pre-operative computed tomography image data. These models are then used to create an onlay template of the frontal sinus, which is used intra-operatively.Results:In a series of 10 patients undergoing osteoplastic flap frontal sinus surgery, the described frontal sinus templates were consistently accurate to within 1 mm.Conclusion:Frontal sinus templates are potentially useful adjuncts to current techniques employed to guide frontal sinus surgery.

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.

Frontal sinus pneumocele caused by a maxillary sinus mucocele

2021 ◽  
Vol 14 (4) ◽  
pp. e242477
Author(s):  
Spyridon Potamianos ◽  
Eftychia Kanioura ◽  
Georgios Chrysovitsiotis ◽  
Evangelos Giotakis
Keyword(s):  
Maxillary Sinus ◽  
Paranasal Sinus ◽  
Frontal Sinus ◽  
Sinus Surgery ◽  
Valve Mechanism ◽  
Patient Reports ◽  
Full Resolution ◽  
Sinus Wall ◽  
The Face ◽  
The Right

A sinus pneumocele is a rare entity caused by obstruction of a paranasal sinus ostium. It is characterised by dilation and expansion of the sinus, with subsequent bony erosion. The most probable mechanism is air trapping in the paranasal sinus, via a one-way valve mechanism. The case presented concerns a 68-year-old Caucasian man, with recurrent episodes of acute rhinosinusitis. Clinical examination and subsequent imaging of the face, revealed a large pneumocele of the right frontal sinus that significantly eroded the posterior sinus wall. A large mucocele of the right maxillary sinus was also noted, extending to the middle meatus, causing full obstruction of the ostiomeatal complex. Endoscopic sinus surgery was performed, the mucocele was removed and the pneumatisation pathway of the frontal sinus was restored. The patient reports full resolution of symptoms and shows no evidence of recurrence, 6 months postoperatively.

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.

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 Frontal Sinus Fractures: A Conservative Shift

2013 ◽  
Vol 6 (3) ◽  
pp. 155-160 ◽  
Author(s):  
William M. Weathers ◽  
Erik M. Wolfswinkel ◽  
Daniel A. Hatef ◽  
Edward I. Lee ◽  
Rodger H. Brown ◽  
...  
Keyword(s):  
Surgical Management ◽  
Conservative Management ◽  
Endoscopic Sinus Surgery ◽  
Frontal Sinus ◽  
New Technologies ◽  
Management Strategies ◽  
Sinus Surgery ◽  
Seat Belts ◽  
Air Bags ◽  
Traditional Approaches

This article reflects on the changing management of frontal sinus fractures. Severity of these injuries has decreased tremendously since the universal adoption of seat belts and air bags. Recently, there has been a shift from aggressive surgical management to more conservative management strategies, some forgoing surgery all together. New technologies, such as bioabsorbable plates and endoscopic sinus surgery, are leading the way in improved surgical management strategies and offer promising alternatives to the more traditional approaches.

First Olfactory Fiber as an Anatomical Landmark for Frontal Sinus Surgery

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

Paranasal Sinus Mucocele Clinical, imagistic and biochemical aspects

2018 ◽  
Vol 69 (8) ◽  
Author(s):  
Doina Vesa ◽  
Cristian Martu ◽  
Razvan Leata ◽  
Ludmila Lozneanu ◽  
luminita Radulescu ◽  
...  
Keyword(s):  
Facial Asymmetry ◽  
Retrospective Case ◽  
Mri Scans ◽  
The One ◽  
Ethmoid Sinuses ◽  
Retrospective Case Study ◽  
Cellular Components ◽  
Ct And Mri

Paranasal mucoceles are a type of cysts that evolve slowly and are asymptomatic; this poses a difficulty in diagnosing the patient because the symptoms can go unnoticed. The mucocele evolves unpredictably. On the one hand, it can become infected turning into pyoceles and on the other hand, it can invade important regions such as the orbital, cranial or genian regions, creating facial asymmetry. This is a retrospective case study of 37 patients diagnosed with sinus mucoceles, followed up by clinical examination and paraclinical tests such as CT and MRI scans. The biochemical components of the liquid from within the mucocele were analyzed and the following criteria were recorded: NaCl-, Cl-, Na+ and cholesterine as well as cellular components such as mastocytes, macrophages, hematocytes and leucocytes. In all cases, the treatment option was surgery with favorable post-operative and follow-up evaluation. The mucoceles that appeared post-operatively (maxillary and ethmoid sinuses) evolved more rapidly than the mucoceles that were induced byan external injury. Longer follow-up of operated patients permitted a more timely diagnosis of recurrences.

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