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Surgery for Frontal Sinus Disease

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Practical Medical and Surgical Management of Chronic Rhinosinusitis

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Abstract

Frontal sinus surgery remains a considerable surgical challenge, given the narrow confines of the frontal recess, need for angled scopes and instruments, and proximity to critical structures. As a result, the surgical management of frontal sinus disease has engendered significant controversy. Successful execution of frontal techniques requires an intimate understanding of frontal sinus anatomy and physiology. This chapter discusses these principles and reviews the central tenets that guide the choice of surgical approach when disease is considered refractory to maximal medical management. Moreover, the current surgical options available for the treatment of frontal sinus disease, including balloon catheter dilation, endoscopic frontal sinusotomy, frontal trephination, endoscopic modified Lothrop procedure, and osteoplastic flap with/without obliteration, are elaborated along with discussion of indications, technique, and outcomes based on current evidence.

Financial Disclosures:

McLean: None

Deckard: None

Batra: consultant (Medtronic), SAB (Merck)

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References

  1. Ellis M. The treatment of frontal sinusitis. J Laryngol Otol. 1954;68:478–90.

    Article  CAS  PubMed  Google Scholar 

  2. Ogston A. Trephining the frontal sinus for catarrhal diseases. Men Chron Manchester. 1884;3:235–8.

    Google Scholar 

  3. Riedel-Schenke H. Cited by Gosdale RH. The radical obliterative frontal sinus operation: A consideration of technical factors in difficult cases. Ann Otol Rhinol Laryngol. 1955;64:470–85.

    Google Scholar 

  4. Lothrop HA. Frontal sinus suppuration. Ann Surg. 1914;59:937–57.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. Lynch RC. The technique of a radical frontal sinus operation which has given me the best results. Laryngoscope. 1921;31:1–5.

    Article  Google Scholar 

  6. Hardy JM, Montgomery WW. Osteoplastic frontal sinusotomy: an analysis of 250 operations. Ann Otol Rhinol Laryngol. 1976;85:523–32.

    Article  CAS  PubMed  Google Scholar 

  7. Kennedy D. Functional endoscopic sinus surgery technique. Arch Otolaryngol. 1985;111:643–9.

    Article  CAS  PubMed  Google Scholar 

  8. Stammberger H. Endoscopic endonasal surgery––concepts in treatment of recurring rhinosinusitis. Part II. Surgical technique. Otolaryngol Head Neck Surg. 1986;94:14–56.

    Google Scholar 

  9. McLaughlin RB, Rehl RM, Lanza DC. Clinically relevant frontal sinus anatomy and physiology. Otolaryngol Clin North Am. 2001;34:1–22.

    Article  PubMed  Google Scholar 

  10. Bolger W, Butzin C, Parsons D. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope. 1991;101:56–64.

    Article  CAS  PubMed  Google Scholar 

  11. Lee W, Kuhn F, Citardi M. 3D computed tomographic analysis of frontal recess anatomy in patients without frontal sinusitis. Otolaryngol Head Neck Surg. 2004;131:164–73.

    Article  PubMed  Google Scholar 

  12. Bent JP, Cuilty-Siller C, Kuhn FA. The frontal cell as a cause of frontal sinus obstruction. Am J Rhinol. 1994;8:185–91.

    Article  Google Scholar 

  13. Messerklinger W. On the drainage of the normal frontal sinus of man. Acta Otolaryngol. 1967;63:176–81.

    Article  CAS  PubMed  Google Scholar 

  14. Citardi MJ, Batra PS. Intraoperative surgical navigation for endoscopic sinus surgery: rationale and indications. Curr Opin Otolaryngol Head Neck Surg. 2007;15:23–7.

    Article  PubMed  Google Scholar 

  15. Kuhn FA, Citardi MJ. Advances in postoperative care following functional endoscopic sinus surgery. Otolaryngol Clin North Am. 1997;30:479–90.

    CAS  PubMed  Google Scholar 

  16. Batra PS. Evidence-based practice: balloon catheter dilation in rhinology. Otolaryngol Clin North Am. 2012;45:993–1004.

    Article  PubMed  Google Scholar 

  17. Bolger WE, Brown CL, Church CA, 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 

  18. Plaza G, Eisenberg G, Montojo J, et al. Balloon dilation of the frontal recess: a randomized clinical trial. Ann Otol Rhinol Laryngol. 2011;120:511–8.

    Article  PubMed  Google Scholar 

  19. Brown CL, Bolger WE. Safety and feasibility of balloon catheter dilation of paranasal sinus ostia: a preliminary investigation. Ann Otol Rhinol Laryngol. 2006;115:293–9.

    Article  PubMed  Google Scholar 

  20. Catalano PJ, Payne SC. Balloon dilation of the frontal recess in patients with chronic frontal sinusitis and advanced sinus disease: an initial report. Ann Otol Rhinol Laryngol. 2009;118:107–12.

    Article  PubMed  Google Scholar 

  21. Heimgartner S, Eckardt J, Simmen D, et al. Limitations of balloon sinuplasty in frontal sinus surgery. Eur Arch Otorhinolaryngol. 2011;268:1463–7.

    Article  CAS  PubMed  Google Scholar 

  22. Weber R, Draf W, Kratzsch B, et al. Modern concepts of frontal sinus surgery. Laryngoscope. 2001;111:137–46.

    Article  CAS  PubMed  Google Scholar 

  23. Kuhn FA. Chronic frontal sinusitis: the endoscopic frontal recess approach. Op Tech Otolaryngol Head Neck Surg. 1996;7:222–9.

    Article  Google Scholar 

  24. Silverman JB, Prasittivatechakool K, Busaba NY. An evidence-based review of endoscopic frontal sinus surgery. Am J Rhinol Allergy. 2009;23:e59–62.

    Article  PubMed  Google Scholar 

  25. Philpott CM, Thamboo A, Lai L, et al. Endoscopic frontal sinusotomy-preventing recurrence or a route to revision? Laryngoscope. 2010;120:1682–6.

    Article  PubMed  Google Scholar 

  26. Chan Y, Melroy CT, Kuhn CA, et al. Long-term frontal sinus patency after endoscopic frontal sinusotomy. Laryngoscope. 2009;119:1229–32.

    Article  PubMed  Google Scholar 

  27. Lee AS, Schaitkin BM, Gillman GS. Evaluating the safety of frontal sinus trephination. Laryngoscope. 2010;120:639–42.

    Article  PubMed  Google Scholar 

  28. Batra PS, Citardi MJ, Lanza DC. Combined endoscopic trephination and endoscopic frontal sinusotomy for management of complex frontal sinus pathology. Am J Rhinol. 2005;19:435–41.

    PubMed  Google Scholar 

  29. Gross CW, Schlosser RJ. The modified Lothrop procedure: lessons learned. Laryngoscope. 2001;111:1302–5.

    Article  CAS  PubMed  Google Scholar 

  30. Batra PS, Cannady SB, Lanza DC. Surgical outcomes of drillout procedures for management of complex frontal sinus pathology. Laryngoscope. 2007;117:927–31.

    Article  PubMed  Google Scholar 

  31. 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 

  32. Naidoo Y. Long-term outcomes for the endoscopic modified Lothrop/Draf III procedure: a 10-year review. Laryngoscope. 2014;124:43–9.

    Article  PubMed  Google Scholar 

  33. Hahn S, Palmer JN, Purkey MT, et al. Indications for external frontal sinus procedures for inflammatory sinus disease. Am J Rhinol Allergy. 2009;23:342–7.

    Article  PubMed  Google Scholar 

  34. Weber R, Draf W, Keerl R, et al. Osteoplastic frontal sinus surgery with fat obliteration: technique and long-term results using magnetic resonance imaging in 82 operations. Laryngoscope. 2000;110:1037–44.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Temple University School of Medicine, 3401 North Broad Street, Philadelphia, PA, USA

    Caitlin McLean MD

  2. Division of Otolaryngology – Head and Neck Surgery, Department of Surgery, Cooper University Hospital, 3 Cooper Plaza, Suite 404, Camden, NJ, USA

    Nathan A. Deckard MD

  3. Department of Otorhinolaryngology – Head and Neck Surgery, Rush Center for Skull Base and Pituitary Surgery, Rush University Medical Center, 1611 W. Harrison St, Suite 550, Chicago, IL, USA

    Pete S. Batra MD, FACS, FARS

Authors
  1. Caitlin McLean MD
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  2. Nathan A. Deckard MD
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  3. Pete S. Batra MD, FACS, FARS
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Corresponding author

Correspondence to Pete S. Batra MD, FACS, FARS .

Editor information

Editors and Affiliations

  1. Department of Otorhinolaryngology Head and Neck Surgery, Rush Center for Skull Base and Pituitary Surgery, Rush University Medical Center, Chicago, Illinois, USA

    Pete S. Batra

  2. Department of Otolaryngology and Head & Neck Surgery, Eastern Virginia Medical School, Norfolk, Virginia, USA

    Joseph K. Han

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© 2015 Springer International Publishing Switzerland

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McLean, C., Deckard, N.A., Batra, P.S. (2015). Surgery for Frontal Sinus Disease. In: Batra, P., Han, J. (eds) Practical Medical and Surgical Management of Chronic Rhinosinusitis. Springer, Cham. https://doi.org/10.1007/978-3-319-16724-4_26

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  • DOI: https://doi.org/10.1007/978-3-319-16724-4_26

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-16723-7

  • Online ISBN: 978-3-319-16724-4

  • eBook Packages: MedicineMedicine (R0)

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