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Frontal Trephination: Indications, Anatomy, Techniques, and Outcomes

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Frontal Sinus Surgery

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Abstract

Given the challenging anatomy of the frontal recess and critical neighboring structures, surgery to the frontal sinus is undertaken in a measured and calculated manner. Historically, frontal sinus surgery was exclusively approached externally. With the advent of the endoscopic era, endoscopic techniques became the work horse for addressing frontal sinus pathology. However, in select situations, there remains a role for external approaches such as trephination.

Trephination allows direct external access to the frontal sinus via a well-masked curvilinear incision in the shadow line of the brow. Entry into the sinus can range from a simple 1–2 mm entry site to permit irrigation from above, to a 2–3 cm bone plate removal for tumor or intracranial access. This chapter describes the indications, techniques, and outcomes of this procedure.

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Author information

Authors and Affiliations

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

    Garret W. Choby & Jayakar V. Nayak

  2. Division of Rhinology and Endoscopic Skull Base Surgery, Department of Otorhinolaryngology – Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA

    Garret W. Choby

Authors
  1. Garret W. Choby
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  2. Jayakar V. Nayak
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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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Choby, G.W., Nayak, J.V. (2019). Frontal Trephination: Indications, Anatomy, Techniques, and Outcomes. In: Lal, D., Hwang, P. (eds) Frontal Sinus Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-97022-6_8

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  • DOI: https://doi.org/10.1007/978-3-319-97022-6_8

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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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