Outcomes After Frontal Sinus Surgery

DeConde, Adam S.; Smith, Timothy L.

doi:10.1016/j.otc.2016.03.024

Cited by 61 publications

(56 citation statements)

References 63 publications

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“…This approach is typically reserved for severe refractory disease but can lead to early post‐operative morbidity due to the breadth of surgically exposed bone, crusting, early synechiae formation, and protracted healing times. Although recent data has suggested fewer complications and reduced morbidity in experienced hands, many otolaryngologists do not possess the experience, or have access to the equipment and navigation required, to confidently carry out a Draf III procedure.…”

Section: Discussionmentioning

confidence: 99%

The “Cross‐court draf IIb” procedure for advanced nasal septum or frontal sinus pathology and nasal septum pathology

Choby

Nayak

2017

The Laryngoscope

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Section: Discussionmentioning

confidence: 99%

The “Cross‐court draf IIb” procedure for advanced nasal septum or frontal sinus pathology and nasal septum pathology

Choby

Nayak

2017

The Laryngoscope

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“…Draf IIa frontal sinusotomy is indicated for a variety of pathologies such as refractory chronic frontal sinusitis, CRS with polyposis, barosinusitis, complicated acute frontal sinusitis that failed Draf I, mucocele and benign tumors. 36 For anatomic location, the ANC, specifically its medial lamella ("vertical bar"), along with the ethmoid bulla are very important landmarks for the FSDP (►Video 1). 10 This procedure demands technical expertise so it is recommended that experienced otolaryngologists should perform it.…”

Section: Draf Iiamentioning

confidence: 99%

“…1,43 In summary, long-term patency rates vary, but a large neoaperture, with maximization of the Draf III extension, is critical for maintain high patency rates after 2 years of surgery. 36,44 Complications Safe and successful FS surgery requires meticulous planning and profound anatomical knowledge. Reducing intraoperative bleeding is mandatory to improve the visualization of the surgical field and, consequently, enhance the safety of the procedure.…”

Section: Videomentioning

confidence: 99%

The Frontal Sinus and Frontal Recess: Anatomical, Radiological and Surgical Concepts

Dassi¹,

Demarco²,

Mangussi‐Gomes³

et al. 2020

Int Arch Otorhinolaryngol

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Introduction The frontal sinus (FS) is the most complex of the paranasal sinuses due to its location, anatomical variations and multiple clinical presentations. The surgical management of the FS and of the frontal recess (FR) is technically challenging, and a complete understanding of its anatomy, radiology, main diseases and surgical techniques is crucial to achieve therapeutic success. Objectives To review the FS and FR anatomy, radiology, and surgical techniques. Data Synthesis The FS features a variety of anatomical, volumetric and dimensional characteristics. From the endoscopic point of view, the FR is the point of greatest narrowing and, to have access to this region, one must know the anatomical limits and the ethmoid cells that are located around the FR and very often block the sinus drainage. Benign diseases such as chronic rhinosinusitis (CRS), mucocele and osteomas are the main pathologies found in the FS; however, there is a wide variety of malignant tumors that can also affect this region and represent a major technical challenge to the surgeon. With the advances in the endoscopic technique, the vast majority of diseases that affect the FS can be treated according to Wolfgang Draf, who systemized the approaches into four types (I, IIa, IIb, III). Conclusion Both benign and malignant diseases that affect the FS and FR can be successfully managed if one has a thorough understanding of the FS and FR anatomy, an individualized approach of the best surgical technique in each case, and the appropriate tools to operate in this region.

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“…Since its validation from Hopkins and colleagues, Sino Nasal Outcome Test -22 (SNOT-22) has become the reference questionnaire to assess health status and health-related quality of life in CRS [9]. It originated from the Rhinosinusitis Outcomes Measure-31 (RSOM-31), developed by Piccirillo and co-authors.…”

Section: Introductionmentioning

confidence: 99%

Quality of Life Outcomes in Frontal Sinus Surgery

Georgalas

Detsis

Geramas

et al. 2020

JCM

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Introduction: Although significant experience has been gained in the technical nuances of endoscopic sinus surgery procedures, the patient-reported outcomes of frontal endoscopic sinus surgery procedures are still poorly understood. In this study we used the validated patient outcome measure Sino Nasal Outcome Test-22 (SNOT-22) to assess the preoperative and postoperative quality of life in patients undergoing extended endoscopic frontal sinus surgery (Draf type 2 and Draf type 3 procedures). Methods: Out of a total of 680 patients undergoing endoscopic sinus and skull base surgery and 186 patients undergoing frontal sinus surgery, 99 chronic rhinosinusitis patients with (CRSwNP) or without (CRSnNP) nasal polyps undergoing Draf 2 or Draf 3 were assessed. Results: The mean preoperative SNOT-22 was 45.6 points for patients undergoing Draf 2 and 59 for patients undergoing Draf 3, while the mean radiological Lund–Mackay Score was 14.3 and 14.5, respectively. Mean SNOT 22 improvement was 22.9 points for Draf 2 and 37 points for Draf 3 respectively and remained significant in all time intervals, including at 4 years after surgery. With the exception of loss of smell/taste, all symptoms improved by a far bigger extent in Draf 3 group, despite the considerably worse starting point. Effect size (Cohen / Standard Deviations) of Draf 3 was greatest in the following symptoms: “being frustrated/restless/irritable” (1.63), “nasal blockage” (1.43), “reduced concentration” (1.35), “fatigue” (1.29) “runny nose” (1.26) and “need to blow nose” (1.17). Frontal sinus (neo) ostium was patent (fully or partly) at last follow up in 98% of Draf 2 patients and in 88% of patients following Draf 3. Patients with non-patent frontal (neo-) ostium however had a mean postoperative SNOT 22 score of 43 compared to 20 of those with patent frontal sinus (neo-) ostium, although the difference was not statistically significant. Conclusion: Patients undergoing Draf 3 have a greater burden of disease, including both nasal and emotional/general symptoms compared to Draf 2 patients; surgery results in improvement in both groups, although Draf 3 patients have the greatest benefit, especially in emotional / general symptons. In this way both groups achieve similar postoperative quality of life, despite the different starting points.

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Outcomes After Frontal Sinus Surgery

Cited by 61 publications

References 63 publications

The “Cross‐court draf IIb” procedure for advanced nasal septum or frontal sinus pathology and nasal septum pathology

The “Cross‐court draf IIb” procedure for advanced nasal septum or frontal sinus pathology and nasal septum pathology

The Frontal Sinus and Frontal Recess: Anatomical, Radiological and Surgical Concepts

Quality of Life Outcomes in Frontal Sinus Surgery

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