Endoscopic Anatomic Characterization of the Frontal Recess and Its Implications in Frontal Sinus Surgery

ORL ◽  
2008 ◽  
Vol 70 (2) ◽  
pp. 84-90 ◽  
Author(s):  
Zhou Bing ◽  
Han Demin ◽  
Liu Huachao ◽  
Huang Qian ◽  
Zhang Luo ◽  
...  
Keyword(s):  
Frontal Sinus ◽  
Sinus Surgery ◽  
Frontal Recess ◽  
Frontal Sinus Surgery

Indications for External Frontal Sinus Procedures for Inflammatory Sinus Disease

2009 ◽  
Vol 23 (3) ◽  
pp. 342-347 ◽  
Author(s):  
Samuel Hahn ◽  
James N. Palmer ◽  
Michael T. Purkey ◽  
David W. Kennedy ◽  
Alexander G. Chiu
Keyword(s):  
Inflammatory Disease ◽  
Frontal Sinus ◽  
Sinus Surgery ◽  
External Approach ◽  
Previous Surgery ◽  
Frontal Recess ◽  
Frontal Sinus Surgery ◽  
Previous Trauma ◽  
History Of ◽  
Type 3

Background In the modern age of endoscopic sinus surgery (ESS), there is an undefined role for external approaches in the treatment of inflammatory disease. This study examines the frontal sinus surgery practices of three experienced rhinologists with a focus on those who underwent an external approach. Our goal was to characterize these patients and propose indications for the use of an external approach alone or in combination with functional ESS (FESS) for frontal sinus inflammatory disease. Methods A retrospective review was performed of frontal sinus procedures performed for inflammatory disease at one institution from 2004 to 2007. Results Seven hundred seventeen procedures were performed, 38 (5.3%) of which were external alone (14 procedures) or in combination with FESS (24 procedures). Osteoplastic flap with obliteration (12/14) made up the majority of external alone procedures and the most common indication was neo-osteogenesis of the frontal recess. Trephination was the most common external adjunct to FESS (12/24), and often was performed for type 3 frontal recess cells or in the initial management of acute frontal bone osteomyelitis (FOM). Twenty-eight of 38 (74%) patients had a history of previous surgery. Of the 10 patients with no history of previous surgery, 6 (60%) had an external adjunct for frontal recess neo-osteogenesis. There were no major complications but 9/38 (23.7%) patients required revision surgery for persistent/recurrent symptoms. Conclusion External approaches alone and in combination with FESS are predominantly secondary to neo-osteogenesis of the frontal recess. Factors associated with neo-osteogenesis include previous trauma, endoscopic surgery, and FOM. External frontal sinus surgery provides adequate management of inflammatory disease but has a high revision rate.

Virtual Mapping of the Frontal Recess: Guiding Safe and Efficient Frontal Sinus Surgery

2017 ◽  
Vol 156 (5) ◽  
pp. 946-951 ◽  
Author(s):  
Neil S. Patel ◽  
Amy C. Dearking ◽  
Erin K. O’Brien ◽  
John F. Pallanch
Keyword(s):  
Frontal Sinus ◽  
Tertiary Care ◽  
Middle Turbinate ◽  
Uncinate Process ◽  
Sinus Surgery ◽  
Preoperative Imaging ◽  
Level Of Evidence ◽  
Frontal Recess ◽  
Frontal Sinus Surgery ◽  
Sinus Opening

Objective To define relationships between the frontal sinus opening, ostia of other frontal recess cells, and endoscopic landmarks and to develop a clinically useful framework to guide frontal sinus surgery. Study Design Retrospective review. Setting Tertiary care academic referral center. Methods Adult patients with computed tomography (CT) without sinonasal pathology were included. Virtual endoscopy (using OsiriX) and corresponding CT reconstructions were used to identify all visible ostia in the frontal recess and characterize their positions in spaces between the uncinate/agger nasi (U), bulla ethmoidalis (EB), and middle turbinate (MT). Results Two hundred sides in 100 patients (median age 51 years, 62% female) were analyzed. The “center” of each map was defined as the intersection of spaces between U, EB, and MT. The frontal sinus opening was in the “center” in 53% of frontal recesses, lateral to this position in 29%, and anterior in 11%. When the frontal sinus opening was at the “center,” anterior ostia drained frontal Kuhn T cells in 51% and intersinus septal cells in 23%. The skull base attachment of the apical strut of the uncinate process demarcated medial and lateral within the space between U and EB, with the opening to the frontal sinus medial in 68% and lateral in 31%. Left-right asymmetry in frontal sinus openings was noted in 46% of patients. Conclusion Combining preoperative imaging and knowledge of these anatomic relationships may facilitate more efficient frontal outflow tract identification and instrumentation. This represents the first and largest description of ostial configurations relative to endoscopic structural landmarks. Level of Evidence: 4

First Olfactory Fiber as an Anatomical Landmark for Frontal Sinus Surgery

2016 ◽  
Vol 77 (S 01) ◽  
Author(s):  
Smita Upadhyay ◽  
Lamia Buohliqah ◽  
Gerival Junior ◽  
Bradley Otto ◽  
Daniel Prevedello ◽  
...  
Keyword(s):  
Frontal Sinus ◽  
Anatomical Landmark ◽  
Sinus Surgery ◽  
Frontal Sinus Surgery

scholarly journals Extended endoscopic frontal nasal sinus surgery in management of chronic and recurrent frontal sinus diseases

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Ahmed Sobhi Abdelaal ◽  
Mohamed Kamel Al Awady ◽  
Tawfik Abdelaty Elkholy
Keyword(s):  
Frontal Sinus ◽  
Anatomical Variation ◽  
Sinus Surgery ◽  
Frontal Sinusitis ◽  
Office Visits ◽  
Nasal Sinus ◽  
Frontal Sinus Surgery ◽  
Operative Care ◽  
Intimate Relation

Abstract Background The anatomical variation of the frontal sinus and its intimate relation to the skull base and orbit makes its surgery demanding. The extended endoscopic frontal sinus surgery allows wide better drainage and preventing the recurrence of the disease. Fourteen patients underwent EEFSS from May 2017 to May 2019. These patients are nine patients presented by chronic recurrent frontal sinusitis, three patients presented by chronic recurrent fronto ethmoidal mucocele and two patients with chronic recurrent external frontal fistula. Draff III done for ten patients of them and Draff IIB done for four patients of them. This study is designed for evaluating the efficacy of the extended endoscopic frontal sinus surgery (E E F S S) in management of chronic and recurrent frontal sinus diseases. Results The neo opening of the restored frontal sinus was remained opened with Draff III with high success rate; two patients from four patients with Draff IIb were with closed nasofrontal duct. The main follow-up was 12 months; the patients were followed up post-operatively for many office visits without any other manifestations. Conclusion The chronic recurrent frontal sinus diseases can be treated successfully with extended endoscopic frontal sinus surgery (E E F S S). The extended endoscopic frontal sinus surgery (Draff III) provides good results with low morbidity and less post-operative care.

11:14: Evidence-Based Review of Endoscopic Frontal Sinus Surgery

2007 ◽  
Vol 137 (2_suppl) ◽  
pp. P74-P75
Author(s):  
Peter Doble ◽  
Robert C Kern ◽  
Nicolas Busaba ◽  
Khajornkiat Prasittivatechakool
Keyword(s):  
Frontal Sinus ◽  
Sinus Surgery ◽  
Evidence Based ◽  
Frontal Sinus Surgery

scholarly journals The Relationship Between the Width of the Frontal Recess and the Frontal Recess Cells in Japanese Patients

2019 ◽  
Vol 12 ◽  
pp. 117955061988494
Author(s):  
Seiichiro Makihara ◽  
Shin Kariya ◽  
Mitsuhiro Okano ◽  
Tomoyuki Naito ◽  
Kensuke Uraguchi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Frontal Sinus ◽  
Significant Positive Correlation ◽  
Japanese Patients ◽  
Cell Types ◽  
Sinus Surgery ◽  
Ct Scans ◽  
Frontal Sinusitis ◽  
Frontal Recess ◽  
The Relationship

Objective: The agger nasi cell (ANC) is an easily identifiable landmark when approaching the frontal sinus. The success of endoscopic frontal sinus surgery may be influenced by the width of the frontal recess (FR). The aim of this study is to examine the relationship between the FR width and the ANC size in Japanese patients. In addition, the effect of various frontal recess cells (FRCs) on the development of frontal sinusitis has been examined. Materials and methods: Multiplanar computed tomography (CT) scans of the nasal cavities and paranasal sinuses in 95 patients (190 sides) before endoscopic sinus surgery were reviewed. The presence of FRCs, the thickness of the frontal beak (FB), the ANC size, and the anterior-to-posterior (A-P) length of the frontal isthmus (FI) and FR were evaluated in patients with and without frontal sinusitis. Results: The prevalence of the ANC, frontal cell types 1, 2, 3, and 4, frontal bullar cell (FBC), suprabullar cell, supraorbital ethmoid cell, and interfrontal sinus septal cell was 85.3%, 11.6%, 0%, 7.9%, 0%, 25.3%, 45.8%, 16.8%, and 15.3%, respectively. The ANC volume showed a significant positive correlation with the A-P length of the FI and FR. The incidence of frontal sinusitis in the patients with FBCs was significantly higher than that without FBCs. Conclusion: A large ANC offers a greater potential to facilitating the approach to the frontal sinus because of the extensiveness of the FR in Japanese patients. The presence of FBCs may be related to a higher incidence of frontal sinusitis.

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