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Management of the Stenosing Frontal Recess

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Frontal Sinus Surgery

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Abstract

Achieving long-term, positive outcomes from frontal surgery can be challenging. Local complications such as scarring, middle turbinate lateralization, and stenosis of surgically enlarged ostia can lead to recurrent sinonasal obstruction and eventual surgical failure. Residual inflammation can also impede mucosal recovery and incite polypoid disease, further compromising surgical results. The frontal sinus is particularly vulnerable to surgical failure given its narrow outflow and difficult accessibility to topical therapies. Patency rates after frontal sinusotomy (Draf IIA) can range anywhere from 67.6% to 92% and may diminish over time, highlighting the need for diligent surveillance following surgery and optimization of the wound healing environment during the postoperative period. This chapter will address management of the stenosing frontal recess. A broad spectrum of therapeutic options have been developed to manage this condition including postoperative debridement, balloon sinus dilation (BSD), frontal stents, bioabsorbable implants, and in-office revision frontal sinusotomy, all of which will be discussed in this chapter.

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Author information

Authors and Affiliations

  1. Department of Otolaryngology, McGill University, Montreal, QC, Canada

    Rickul Varshney MD

  2. Department of Head and Neck Surgery, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, USA

    Jivianne T. Lee MD

Authors
  1. Rickul Varshney MD
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  2. Jivianne T. Lee MD
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Editor information

Editors and Affiliations

  1. Prof of Otolaryngology, Mayo Clinic College of Medicine and Science, Associate Dean, Mayo Clinic School of Continuous Professional Development, Consultant, Dept of Otolaryngology-Head and Neck Surgery, Consultant (Joint), Dept of Neurological Surgery, Mayo Clinic, Phoenix, AZ, USA

    Devyani Lal

  2. Professor and Chief, Division of Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA

    Peter H. Hwang

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Varshney, R., Lee, J.T. (2019). Management of the Stenosing Frontal Recess. In: Lal, D., Hwang, P. (eds) Frontal Sinus Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-97022-6_11

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  • DOI: https://doi.org/10.1007/978-3-319-97022-6_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-97021-9

  • Online ISBN: 978-3-319-97022-6

  • eBook Packages: MedicineMedicine (R0)

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