Skip to main content

Outcomes and Quality of Life from Frontal Sinus Surgery

  • Chapter
  • First Online:
Frontal Sinus Surgery

Abstract

The goal of surgical treatment of frontal sinusitis is to improve the quality of life of patients. The purpose of this chapter is to summarize the evidence for the outcomes and quality of life related to surgical intervention of the frontal sinus. Studies report very high patency rates for Draf IIA procedures, and Draf III procedures have high rates of subjective improvement and neo-ostium patency in patients with recalcitrant disease. Balloon catheter dilation has shown favorable safety and effectiveness, while frontal sinus stenting serves as an adjunct to help decrease the risk of stenosis. As with all techniques and indications for surgical intervention, patient selection remains a key factor in outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Chiu AG. Frontal sinus surgery: its evolution, present standard of care, and recommendations for current use. Ann Otol Rhinol Laryngol Suppl. 2006;196:13–9.

    Article  PubMed  Google Scholar 

  2. Wormald PJ. Salvage frontal sinus surgery: the endoscopic modified lothrop procedure. Laryngoscope. 2003;113(2):276–83.

    Article  PubMed  Google Scholar 

  3. Draf W. Endonasal micro-endoscopic frontal sinus surgery: the fulda concept. Oper Tech Otolaryngol Head Neck Surg. 1991;2(4):234–40.

    Article  Google Scholar 

  4. Sillers MJ, Lay KF. Balloon catheter dilation of the frontal sinus ostium. Otolaryngol Clin N Am. 2016;49(4):965–74.

    Article  Google Scholar 

  5. Heimgartner S, Eckardt J, Simmen D, Briner HR, Leunig A, Caversaccio MD. Limitations of balloon sinuplasty in frontal sinus surgery. Eur Arch Otorhinolaryngol. 2011;268(10):1463–7.

    Article  CAS  PubMed  Google Scholar 

  6. Hunter B, Silva S, Youngs R, Saeed A, Varadarajan V. Long-term stenting for chronic frontal sinus disease: case series and literature review. J Laryngol Otol. 2010;124:1216–22.

    Article  CAS  PubMed  Google Scholar 

  7. Smith TL, Kern R, Palmer JN, et al. Medical therapy vs surgery for chronic rhinosinusitis: a prospective, multi-institutional study with 1-year follow-up. Int Forum Allergy Rhinol. 2013;3(1):4–9.

    Article  PubMed  Google Scholar 

  8. DeConde AS, Mace JC, Alt JA, Soler ZM, Orlandi RR, Smith TL. Investigation of change in cardinal symptoms of chronic rhinosinusitis after surgical or ongoing medical management. Int Forum Allergy Rhinol. 2015;5(1):36–45.

    Article  PubMed  Google Scholar 

  9. DeConde AS, Mace JC, Alt JA, Schlosser RJ, Smith TL, Soler ZM. Comparative effectiveness of medical and surgical therapy on olfaction in chronic rhinosinusitis: a prospective, multi-institutional study. Int Forum Allergy Rhinol. 2014;4:725–33.

    Article  PubMed  PubMed Central  Google Scholar 

  10. DeConde AS, Suh JD, Mace JC, Alt JA, Smith TL. Outcomes of complete vs targeted approaches to endoscopic sinus surgery. Int Forum Allergy Rhinol. 2015;5(8):691–700.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Naidoo Y, Wen D, Bassiouni A, Keen M, Wormald PJ. Long-term results after primary frontal sinus surgery. Int Forum Allergy Rhinol. 2012;2(3):185–90.

    Article  PubMed  Google Scholar 

  12. DeConde AS, Smith TL. Outcomes after frontal sinus surgery: an evidence-based review. Otolaryngol Clin N Am. 2016;49(4):1019–33.

    Article  Google Scholar 

  13. Friedman M, Bliznikas D, Vidyasagar R, Joseph NJ, Landsberg R. Long-term results after endoscopic sinus surgery involving frontal recess dissection. Laryngoscope. 2006;116(4):573–9.

    Article  PubMed  Google Scholar 

  14. Chan Y, Melroy CT, Kuhn CA, Kuhn FL, Daniel WT, Kuhn FA. Long-term frontal sinus patency after endoscopic frontal sinusotomy. Laryngoscope. 2009;119(6):1229–32.

    Article  PubMed  Google Scholar 

  15. Askar MH, Gamea A, Tomoum MO, Elsherif HS, Ebert C, Senior BA. Endoscopic management of chronic frontal sinusitis: prospective quality of life analysis. Ann Otol Rhinol Laryngol. 2015;124(8):638–48.

    Article  PubMed  Google Scholar 

  16. Chandra RK, Palmer JN, Tanqsujarittham T, Kennedy DW. Factors associated with failure of frontal sinusotomy in the early follow-up period. Otolaryngol Head Neck Surg. 2004;131(4):514–8.

    Article  PubMed  Google Scholar 

  17. Hosemann W, Kuhnel T, Held P, Wagner W, Felderhoff A. Endonasal frontal sinusotomy in surgical management of chronic sinusitis: a critical evaluation. Am J Rhinol. 1997;11(1):1–9.

    Article  CAS  PubMed  Google Scholar 

  18. Wigand ME, Hosemann WG. Endoscopic surgery for frontal sinusitis and its complications. Am J Rhinol. 1991;5(3):85–9.

    Article  Google Scholar 

  19. Valdes CJ, Bogado M, Samaha M. Causes of failure in endoscopic frontal sinus surgery in chronic rhinosinusitis patients. Int Forum Allergy Rhinol. 2014;4(6):502–6.

    Article  PubMed  Google Scholar 

  20. Weber R, Draf W, Kratzsch B, Hosemann W, Schaefer SD. Modern concepts of frontal sinus surgery. Laryngoscope. 2001;111(1):137–46.

    Article  CAS  PubMed  Google Scholar 

  21. Gross WE, Gross CW, Becker D, Moore D, Phillips D. Modified transnasal endoscopic lothrop procedure as an alternative to frontal sinus obliteration. Otolaryngol Head Neck Surg. 1995;113(4):427–34.

    Article  CAS  PubMed  Google Scholar 

  22. Chen PG, Wormald PJ, Payne SC, Gross WE, Gross CW. A golden experience: fifty years of experience managing the frontal sinus. Laryngoscope. 2016;126:802–7.

    Article  PubMed  Google Scholar 

  23. Eloy JA, Friedel ME, Kuperan AB, Govindaraj S, Folbe AJ, Liu JK. Modified mini-lothrop/extended draf IIB procedure for contralateral frontal sinus disease: a case series. Int Forum Allergy Rhinol. 2012;2:321–4.

    Article  PubMed  Google Scholar 

  24. Turner JH, Vaezeafshar R, Hwang PH. Indications and outcomes for draf IIB frontal sinus surgery. Am J Rhinol Allergy. 2016;30(1):70–3.

    Article  PubMed  Google Scholar 

  25. Metson R, Sindwani R. Endoscopic surgery for frontal sinusitis–a graduated approach. Otolaryngol Clin North Am. 2004;37:411–22.

    Article  PubMed  Google Scholar 

  26. Hardy JM, Montgomery WW. Osteoplastic frontal sinusotomy: an analysis of 250 operations. Ann Otol Rhinol Laryngol. 1976;85(4 pt 1):523–32.

    Article  CAS  PubMed  Google Scholar 

  27. Weber R, Draf W, Keerl R, et al. Osteoplastic frontal sinus surgery with fat obliteration: techniques and long term results using MRI in 82 operations. Laryngoscope. 2000;110:1037–44.

    Article  CAS  PubMed  Google Scholar 

  28. Sindwani R, Metson R. The impact of image-guidance on osteoplastic frontal sinus obliteration surgery. Otolaryngol Head Neck Surg. 2004;131:150–5.

    Article  PubMed  Google Scholar 

  29. Close LG, Lee NK, Leach JL, Manning SC. Endoscopic resection of the intranasal frontal sinus floor. Ann Otol Rhinol Laryngol. 1994;103:952–8.

    Article  CAS  PubMed  Google Scholar 

  30. Anderson P, Sindwani R. Safety and efficacy of the endoscopic modified lothrop procedure: a systematic review and meta-analysis. Laryngoscope. 2009;119:1828–33.

    Article  PubMed  Google Scholar 

  31. Tran KN, Beule AG, Singal D, Wormald PJ. Frontal ostium restenosis after the endoscopic modified lothrop procedure. Laryngoscope. 2007;117:1457–62.

    Article  PubMed  Google Scholar 

  32. Naidoo Y, Bassiouni A, Keen M, Wormald PJ. Long-term outcomes for the endoscopic modified lothrop/draf III procedure: a 10-year review. Laryngoscope. 2014;124(1):43–9.

    Article  PubMed  Google Scholar 

  33. Bassiouni A, Wormald PJ. Role of frontal sinus surgery in nasal polyp recurrence. Laryngoscope. 2013;123(1):36–41.

    Article  PubMed  Google Scholar 

  34. Weiss RL, Church CA, Kuhn FA. Long-term outcome analysis of balloon catheter sinusotomy: two year follow up. Otolaryngol Head Neck Surg. 2008;139:S38–46.

    Article  PubMed  Google Scholar 

  35. Karanfilov B, Silvers S, Pasha R, et al. Office-based balloon sinus dilation: a prospective, multicenter study of 203 patients. Int Forum Allergy Rhinol. 2013;3(5):404–11.

    Article  PubMed  Google Scholar 

  36. Prince A, Bhattacharyya N. An analysis of adverse event reporting in balloon sinus procedures. Otolaryngol Head Neck Surg. 2016;154(4):748–53.

    Article  PubMed  Google Scholar 

  37. Bolger WE, Brown CL, Church AC, et al. Safety and outcomes of balloon catheter sinusotomy: a multicenter 24-week analysis in 115 patients. Otolaryngol Head Neck Surg. 2007;137:10–20.

    Article  PubMed  Google Scholar 

  38. Kuhn FA, Church CA, Goldberg AN, et al. Balloon catheter sinusotomy: one-year follow-up – outcomes and role in functional endoscopic sinus surgery. Otolaryngol Head Neck Surg. 2008;139:S27–37.

    Article  PubMed  Google Scholar 

  39. Plaza G, Eisenberg G, Montojo J, Onrubia T, Urbasos M, O’Connor C. Balloon dilation of the frontal recess: a randomized clinical trial. Ann Otol Rhinol Laryngol. 2011;120:511–8.

    Article  PubMed  Google Scholar 

  40. Hathorn IF, Pace-Asciak P, Habib AR, Sunkaraneni V, Javer AR. Randomized controlled trial: hybrid technique using balloon dilation of the frontal sinus drainage pathway. Int Forum Allergy Rhinol. 2015;5(2):167–73.

    Article  PubMed  Google Scholar 

  41. Eloy JA, Friedel ME, Eloy JD, Govindaraj S, Folbe AJ. In-office balloon dilation of the failed frontal sinusotomy. Otolaryngol Head Neck Surg. 2012;146(2):320–2.

    Article  PubMed  Google Scholar 

  42. Wycherly BJ, Manes RP, Mikula SK. Initial clinical experience with balloon dilation in revision frontal sinus surgery. Ann Otol Rhinol Laryngol. 2010;119(7):468–71.

    Article  PubMed  Google Scholar 

  43. Perloff J, Palmer J. Evidence of bacterial biofilms on frontal recess stem in patients with chronic rhinosinusitis. Am J Rhinol. 2004;18:377–80.

    Article  PubMed  Google Scholar 

  44. Bendouah Z, Barbeau J, Hamad WA, Desrosiers M. Biofilm formation by staphylococcus aureus and pseudomonas aeruginosa is associated with an unfavorable evolution after surgery for chronic sinusitis and ansal polyposis. Otolaryngol Head Neck Surg. 2006;134(991):996.

    Google Scholar 

  45. Foreman A, Wormald PJ. Different biofilms, different disease? A clinical outcomes study. Laryngoscope. 2010;120:1701–6.

    Article  PubMed  Google Scholar 

  46. Psaltis AJ, Weitzel EK, Ha KR, Wormald PJ. The effect of bacterial biofilms on post-sinus surgical outcomes. Am J Rhinol. 2008;22:1–6.

    Article  PubMed  Google Scholar 

  47. Chadwell JS, Gustafson LM, Tami TA. Toxic shock syndrome associated with frontal sinus stents. Otolaryngol Head Neck Surg. 2001;124(5):573–4.

    Article  CAS  PubMed  Google Scholar 

  48. Weber R, Mai R, Hosemann W, Draf W, Toffel P. The success of 6-month stenting in endonasal frontal sinus surgery. Ear Nose Throat J. 2000;79(12):930–2.

    CAS  PubMed  Google Scholar 

  49. Banhiran W, Sargi Z, Collins W, Kaza S, Casiano R. Long term effect of stenting after an endoscopic modified lothrop procedure. Am J Rhinol. 2006;20(6):595–9.

    Article  PubMed  Google Scholar 

  50. Murr AH, Smith TL, Hwang PH, et al. Safety and efficacy of a novel bioabsorbable, steroid-eluting sinus stent. Int Forum Allergy Rhinol. 2011;1(1):23–32.

    Article  PubMed  Google Scholar 

  51. Marple BF, Smith TL, Han JK, et al. Advance II: a prospective, randomized study assessing safety and efficacy of bioabsorbable steroid-releasing sinus implants. Otolaryngol Head Neck Surg. 2012;146(6):1004–11.

    Article  PubMed  Google Scholar 

  52. Han JK, Marple BF, Smith TL, et al. Effect of steroid-releasing sinus implants on postoperative medical and surgical interventions: an efficacy meta-analysis. Int Forum Allergy Rhinol. 2012;2(4):271–9.

    Article  PubMed  Google Scholar 

  53. Valentine R, Athanasiadis T, Moratti S, Robinson S, Wormald PJ. The efficacy of a novel chitosan gel on hemostasis after endoscopic sinus surgery in a sheep model of chronic rhinosinusitis. Am J Rhinol Allergy. 2009;23(1):71–5.

    Article  PubMed  Google Scholar 

  54. Ngoc Ha T, Valentine R, Moratti S, Robinson S, Hanton L, Wormald PJ. A blinded randomized controlled trial evaluating the efficacy of chitosan gel on ostial stenosis following endoscopic sinus surgery. Int Forum Allergy Rhinol. 2013;3(7):573–80.

    Article  PubMed  Google Scholar 

  55. Valentine R, Athanasiadis T, Moratti S, Hanton L, Robinson S, Wormald PJ. The efficacy of a novel chitosan gel on hemostasis and wound healing after endoscopic sinus surgery. Am J Rhinol Allergy. 2010;24(1):70–5.

    Article  PubMed  Google Scholar 

  56. Muzzarelli A. Chitin and chitosan: unique cationic polysaccharides. In: Mark H, Bikales N, Overberger CG, Menges G, Kroschwitz J, editors. In encyclopedia of polymer science and engineering, vol. 430. Hoboken: Wiley Interscience; 1990.

    Google Scholar 

  57. Athanasiadis T, Beule AG, Robinson BH, Robinson SR, Shi Z, Wormald PJ. Effects of a novel chitosan gel on mucosal wound healing following endoscopic sinus surgery in a sheep model of chronic rhinosinusitis. Laryngoscope. 2008;118:1088–94.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Southwood, J.E., Loehrl, T.A., Poetker, D.M. (2019). Outcomes and Quality of Life from Frontal Sinus Surgery. In: Lal, D., Hwang, P. (eds) Frontal Sinus Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-97022-6_25

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-97022-6_25

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-97021-9

  • Online ISBN: 978-3-319-97022-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics