Rotation Flaps after Draf Procedures: A Cadaver Study

Abstract

Objective: To describe the anatomy and application of local mucosal flaps to reduce cicatricial scarring of the frontal recess after Draf IIB and Draf III procedures.

Method: Description and illustration of the surgical technique of 2 local mucosal flaps after Draf IIB and III procedures in a cadaveric model.

Results: Two distinct local rotation flaps can be successfully used after Draf IIB and Draf III procedures. 1) Prior to superior middle turbinectomy, a medially based mucosal flap is elevated from the medial aspect of the middle turbinate to the nasal septum. This flap is then placed on the posteromedial raw bone of the frontal recess after the Draf IIB. 2) Bilateral posteriorly based flaps are elevated off of the anterosuperior septum prior to the septectomy in a Draf III procedure. After the drillout is performed, the mucosal flaps are rotated to cover the frontal sinus posterior table.

Conclusion: Use of local mucosal flaps to provide primary healing after Draf IIB and Draf III procedures is technically feasible and may decrease the risk of restenosis after frontal sinus surgery.