Modern Concepts of Frontal Sinus Surgery

Weber, Rainer; Draf, Wolfgang; Kratzsch, Barbara; Hosemann, Werner; Schaefer, Steven David

doi:10.1097/00005537-200101000-00024

Cited by 256 publications

(204 citation statements)

References 54 publications

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“…Extended endoscopic techniques such as EMLP (Draf III) is technically demanding [3][4][5], but may still involve a difficulty of intraoperative identification of the frontal sinus. In revision cases, the loss of normal anatomic landmarks, scarring, and the occurrence of reactive bone sclerosis make surgery more difficult [6].…”

Section: Discussionmentioning

confidence: 99%

“…Our EMLP with transseptal approach was a modification of the original EMLP or Draf III [3,5]. In the original EMLP, initially the bilateral frontal sinuses are opened and continuously interfrontal septum and nasal septum are removed.…”

Section: Discussionmentioning

confidence: 99%

“…We, however, routinely perform this procedure, because the approach may be simple in comparison with other classical EMLP [3]. The fact that prominent complications were not observed during or after surgery was the ground to perform this procedure.…”

Section: Discussionmentioning

confidence: 99%

“…The surgeon loses sight of tip of instruments, if he or she has little practice in angled endoscopes. During EMLP, some authors use 30-or 45-degree endoscope [3,4], and the main author and others use 70°endoscope [10,11] for direct visualization of the frontal sinus and the removal of the frontal sinus floors. Thus it is desirable that physicians managing frontal diseases should practice handling angled endoscopes.…”

Section: Discussionmentioning

confidence: 99%

“…However, ESS for the frontal sinus remains problematic, because of the complex anatomy and large anatomical variation of the frontal recess [1,2]. More extensive procedures such as the endoscopic modified Lothrop procedure (EMLP) or Draf III procedure is technically demanding but still has a difficulty of surgical access associated with greater risk [3][4][5]. Thus, a simple technique for safe and effective frontal sinus surgery is critical.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Endoscopic Transseptal Approach to Frontal Sinus Disease

Nishiike

Yoda

Shikina

et al. 2015

Indian J Otolaryngol Head Neck Surg

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This paper describes an endoscopic transseptal approach to identify and access the frontal sinus and reviews the clinical cases. Between May 2004 and July 2010, endoscopic modified Lothrop procedure (EMLP) with transseptal approach was performed on sixteen patients. The indications for EMLP were complicated frontal sinusitis or cyst, revision surgery for failed frontal sinusotomy or Lynch procedure, or trauma cases. The first step of this procedure was to open a window in the bilateral anterior portion of the middle turbinates and nasal septum. The nasal septum, which could be observed through the window, should be the landmark of the midline during the surgery. A drill bur was raised up just behind the nasal bone along the midline of the nose. After the bilateral frontal sinuses and their posterior walls were confirmed, the interfrontal septum was removed superiorly. We reviewed the clinical records of patients who underwent the EMLP with transseptal approach. We have managed sixteen patients in this fashion. Neither intracranial nor orbital complications were encountered during or after surgery.Endoscopic transseptal frontal sinus surgery is simple to perform, and does not cause severe complications.

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