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The Egyptian Journal of Otolaryngology
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External endoscopic multiportal frontal sinus obliteration for laterally pneumatized frontal sinus: a feasibility study

The Egyptian Journal of Otolaryngology volume 34, pages 105–110 (2018)Cite this article

Abstract

Introduction

Osteoplastic flap procedure is a standard method used for frontal sinus obliteration. Endoscopic external frontal sinus obliteration is a minimally invasive new technique confined to small-sized and medium-sized pneumatized frontal sinuses.

Objective

The aim of this study was assess the feasibility and surgical application of this technique for far-lateral pneumatized frontal sinuses.

Materials and methods

Ten sides of adult dry skull were assessed for frontal sinus pneumatization and supraorbital cells by computerized tomography. Three sides were selected with frontal sinus pneumatization extending beyond midorbital line. Feasibility of obliteration of frontal sinus was tested. Endoscopic external multiportal frontal sinus approach was done using angled endoscopy and standard instrumentation. Classic frontal sinus trephine port was performed initially to safely locate the frontal sinus. In-situ nondisplaced superiorly based miniosteoplastic flap reaching to midorbital plane was performed providing another port. Additional lateral trephine port beyond midorbital plane was performed. Angled endoscopy and standard instrumentation were used reciprocally through different ports to reach different areas of frontal sinus. Outcome parameters were ability to reach corners of frontal sinus, remove sinus septae and nasofrontal duct, and maintain integrity of anterior wall of frontal sinus. Surgical application was done in two cases of frontal sinus mucocele and meningoencephalocele.

Results

In three laterally pneumatized frontal sinuses of dry skulls, corners, septae, and nasofrontal ducts could be handled using external multiportal endoscopic approach without disruption of anterior frontal wall. Three ports allowed two-hand surgical technique. Surgical application in two cases with follow-up over 6 months revealed no significant complication. Subcutaneous collection developed in one case after 2 weeks and resolved with medical treatment.

Conclusion

External endoscopic multiportal obliteration is feasible for frontal sinuses with lateral pneumatization beyond midorbital line. This technique is minimally invasive with less morbidity. Long-term follow-up in a larger series is needed.

References

  1. Bockmühl U. Osteoplastic frontal sinusotomy and reconstructon of frontal defects. In: Kountakis SE, Senior BA, Draf W, editors. The frontal sinus. Berlin Heidelberg, Germany: Springer-Verlag; 2005. 281–289

    Chapter  Google Scholar 

  2. Philpott CM, McKiernan DC, Javer AR. Selecting the best approach to the frontal sinus. Indian J Otolaryngol Head Neck Surg 2011; 63:79–84.

    Article  Google Scholar 

  3. Chouake RJ, Miles BA. Current opinion in otolaryngology and head and neck surgery: frontal sinus fractures. Curr Opin Otolaryngol Head Neck Surg 2017; 25:326–331.

    Article  Google Scholar 

  4. Ung F, Sindwani R, Metson R. Endoscopic frontal sinus obliteration: a new technique for the treatment of chronic frontal sinusitis. Otolaryngol Head Neck Surg 2005; 133:551–555.

    Article  Google Scholar 

  5. Carniol ET, Vázquez A, Patel TD, Liu JK, Eloy JA. Utility of intraoperative flexible endoscopy in frontal sinus surgery. Allergy Rhinol (Providence) 2017; 8:81–84.

    Article  Google Scholar 

  6. Eloy JA, Marchiano E, Vázquez A. Extended endoscopic and open sinus surgery for refractory chronic rhinosinusitis. Otolaryngol Clin North Am 2017; 50:165–182.

    Article  Google Scholar 

  7. Yüksel Aslier NG, Karabav N, Zeybek G, Keskinoglu P, Kiray A, Sütay S, Ecevit MC. The classification of frontal sinus pneumatization patterns by CT-based volumetry. Surg Radiol Anat 2016; 38:923–930.

    Article  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Otorhinolaryngology Head and Neck Surgery, Fayoum University, 128 Gisr El Suis heliopolis, Faiyum, Egypt

    Sameh M. Amin MD

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  1. Sameh M. Amin MD
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Correspondence to Sameh M. Amin MD.

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Amin, S.M. External endoscopic multiportal frontal sinus obliteration for laterally pneumatized frontal sinus: a feasibility study. Egypt J Otolaryngol 34, 105–110 (2018). https://doi.org/10.4103/ejo.ejo_89_17

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  • DOI: https://doi.org/10.4103/ejo.ejo_89_17

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