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Endoscopic agger nasi type Draf IIb treatment for frontal sinus lesions

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ABSTRACT

Treatment of frontal sinus using surgery is complicated owing to the complex anatomical structure of the sinus region. The aim of the present study was to investigate the efficacy and safety of Draf IIb endoscopic frontal sinus surgery treatment for frontal sinus lesions using the agger nasi approach on 19 patients (28 left or and right nasal cavities). A 10–12 mm excision of the upper frontal maxilla was performed for endoscopic resection between the middle turbinate and lateral nasal wall. No serious complications in frontal sinus surgery treatment for the removal of the frontal sinus were observed. Patients were followed up after surgery for 6–36 months. Chronic sinusitis and nasal polyps were identified in 10 cases (19 left or and right nasal cavities; disease control, 15 left or and right nasal cavities; and disease partial control, 4 left or and right nasal cavities). Frontal sinus inverted papilloma was observed in 9 cases (9 left or and right nasal cavities). Frontal sinus inverted papilloma were successfully treated in 8 cases, and 1 case of recurrence was observed. In conclusion, the nasal endoscopic Draf IIb agger nasi approach is a minimally invasive treatment for frontal sinus lesions. This surgical procedure is safe and less complicated and may be applied in the clinic.

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Preoperative CT scan of inverted papilloma of frontal sinus. CT, computed tomography.
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f1-etm-0-0-3467: Preoperative CT scan of inverted papilloma of frontal sinus. CT, computed tomography.

Mentions: A total of 19 cases (28 left or and right nasal cavities) of frontal sinus lesion were diagnosed via endoscopic sinus surgery at the Henan Provincial People's Hospital during the period November 2011 to June 2014. Of the 19 cases, 13 male and 6 female cases of frontal sinus lesions were identified. Patients were aged 20–64 years, with an average age of 42 years, and the period of frontal sinus lesion was 6 months to 11 years. According to the criteria of Haikou (2), there were varying degrees of other sinusitis or nasal polyps associated with chronic frontal sinusitis in 10 cases. Seven cases with 13 left or and right nasal cavities of type II phase 3 and 3 cases with 6 left or and right nasal cavities of type III were also identified. The visual analogue scale (VAS) score was measured between 7 and 10 points. According to the criteria of Krouse (3), frontal sinus inverted papilloma of stage III was identified in 9 cases with 9 left or and right nasal cavities. The main clinical manifestations were a frontal headache, stuffy nose, purulent nasal discharge and pus. A preoperative horizontal position of computed tomography (CT) scan of nasal sinuses is shown in Fig. 1. The coronal and sagittal sinus were reconstructed. Antibiotics, and topical nasal spray hormone with oral steroids were administered to the patients, 7–10 days prior to surgery of chronic sinusitis. Oral mucus promoting discharge agent was administered and the nasal cavity was rinsed with physiological saline prior to surgery.


Endoscopic agger nasi type Draf IIb treatment for frontal sinus lesions
Preoperative CT scan of inverted papilloma of frontal sinus. CT, computed tomography.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998003&req=5

f1-etm-0-0-3467: Preoperative CT scan of inverted papilloma of frontal sinus. CT, computed tomography.
Mentions: A total of 19 cases (28 left or and right nasal cavities) of frontal sinus lesion were diagnosed via endoscopic sinus surgery at the Henan Provincial People's Hospital during the period November 2011 to June 2014. Of the 19 cases, 13 male and 6 female cases of frontal sinus lesions were identified. Patients were aged 20–64 years, with an average age of 42 years, and the period of frontal sinus lesion was 6 months to 11 years. According to the criteria of Haikou (2), there were varying degrees of other sinusitis or nasal polyps associated with chronic frontal sinusitis in 10 cases. Seven cases with 13 left or and right nasal cavities of type II phase 3 and 3 cases with 6 left or and right nasal cavities of type III were also identified. The visual analogue scale (VAS) score was measured between 7 and 10 points. According to the criteria of Krouse (3), frontal sinus inverted papilloma of stage III was identified in 9 cases with 9 left or and right nasal cavities. The main clinical manifestations were a frontal headache, stuffy nose, purulent nasal discharge and pus. A preoperative horizontal position of computed tomography (CT) scan of nasal sinuses is shown in Fig. 1. The coronal and sagittal sinus were reconstructed. Antibiotics, and topical nasal spray hormone with oral steroids were administered to the patients, 7–10 days prior to surgery of chronic sinusitis. Oral mucus promoting discharge agent was administered and the nasal cavity was rinsed with physiological saline prior to surgery.

View Article: PubMed Central - PubMed

ABSTRACT

Treatment of frontal sinus using surgery is complicated owing to the complex anatomical structure of the sinus region. The aim of the present study was to investigate the efficacy and safety of Draf IIb endoscopic frontal sinus surgery treatment for frontal sinus lesions using the agger nasi approach on 19 patients (28 left or and right nasal cavities). A 10–12 mm excision of the upper frontal maxilla was performed for endoscopic resection between the middle turbinate and lateral nasal wall. No serious complications in frontal sinus surgery treatment for the removal of the frontal sinus were observed. Patients were followed up after surgery for 6–36 months. Chronic sinusitis and nasal polyps were identified in 10 cases (19 left or and right nasal cavities; disease control, 15 left or and right nasal cavities; and disease partial control, 4 left or and right nasal cavities). Frontal sinus inverted papilloma was observed in 9 cases (9 left or and right nasal cavities). Frontal sinus inverted papilloma were successfully treated in 8 cases, and 1 case of recurrence was observed. In conclusion, the nasal endoscopic Draf IIb agger nasi approach is a minimally invasive treatment for frontal sinus lesions. This surgical procedure is safe and less complicated and may be applied in the clinic.

No MeSH data available.


Related in: MedlinePlus