Endoscopic Resection of the Intranasal Frontal Sinus Floor

Abstract

The current accepted treatment for chronic frontal sinus disease unresponsive to medical management and endoscopic surgery is an external approach to either obliterate the sinus or restore communication to the nasal cavity. Here reported is an endoscopic approach for resection of the intranasal frontal sinus floor, a modification of a procedure first described by Lothrop in 1899. Eleven patients underwent this operation from April 1993 to December 1993. One complication, a cerebrospinal fluid leak treated successfully endoscopically, has occurred. Of the 7 patients followed up 3 months or longer after surgery, only 1 has developed symptoms of recurrent frontal sinusitis. On the basis of this limited preliminary experience, the endoscopic Lothrop procedure shows promise as an effective operation designed to establish a physiologic communication between the frontal sinus and the nasal cavity in selected patients who would otherwise be candidates for an external approach.

Keywords

chronic frontal sinusitis sinus endoscopic treatment

Get full access to this article

View all access options for this article.

References

Goodale

Montgomery

. Experiences with the osteoplastic anterior wall approach to the frontal sinus. Case histories and recommendations. Arch Otolaryngol 1958; 68: 271–83.

Sessions

Alford

Stratton

Ainsworth

Shill

. Current concepts of frontal sinus surgery: An appraisal of the osteoplastic flap-fat obliteration operation. Laryngoscope 1972; 82: 918–30.

Bordley

Bosley

. Mucoceles of the frontal sinus: Causes and treatment. Ann Otol Rhinol Laryngol 1973; 82: 696–702.

Schenck

. Frontal sinus disease: III. Experimental and clinical factors in failure of the frontal osteoplastic operation. Laryngoscope 1975; 85: 76–92.

Lynch

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

Rubin

Lund

Salmon

. Frontoethmoidectomy in the treatment of mucoceles. A neglected operation. Arch Otolaryngol Head Neck Surg 1986; 112: 434–6.

Neel

III McDonald

Facer

. Modified Lynch procedure for chronic frontal sinus diseases: Rationale, technique, and long-term results. Laryngoscope 1987; 97: 1274–9.

Perko

. Endoscopic surgery of the frontal sinus without external approach. Rhinology 1989; 27: 119–23.

Schaefer

. Endoscopic management of frontal sinus disease. Laryngoscope 1990; 100: 155–60.

10.

Hosemann

Leuwer

Wigand

. Die Endonasale Endoskopisch Kontrollierte Stirnhöhlenoperation bei Mukopyozelen und Empyemen. Laryngol Rhinol Otol (Stuttg) 1992; 71: 181–6.

11.

Hosemann

Göde

Wigand

. Indications, technique and results of endonasal endoscopic ethmoidectomy. Acta Otorhinolaryngol Belg 1993; 47: 73–83.

12.

Loury

. Endoscopic frontal recess and frontal sinus ostium dissection. Laryngoscope 1993; 103: 455–8.

13.

Lothrop

. The anatomy and surgery of the frontal sinus and anterior ethmoid cells. Ann Surg 1899; 29: 175–215.

14.

Lothrop

. The treatment of frontal sinus suppuration. Laryngoscope 1917; 27: 1–13.

15.

Hilding

. Experimental surgery of the nose and sinuses. II. Gross results following the removal of the intersinous septum and of strips of mucous membrane from the frontal sinus of the dog. Arch Otolaryngol 1933; 17: 321–7.

16.

Montgomery

. Surgery of the upper respiratory system. Philadelphia, Pa: Lea & Febiger, 1971: 99–126.