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Endoscopic agger nasi type Draf IIb treatment for frontal sinus lesions

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.


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Postoperative endoscopic view of removed inverted papilloma for frontal sinus.
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f3-etm-0-0-3467: Postoperative endoscopic view of removed inverted papilloma for frontal sinus.

Mentions: The operation was performed under general anesthesia. A 0° nasal endoscope (7230AA, Karl Storz, Tuttlingen, Germany) with conventional surgical resection and uncinate process between the middle turbinate and lateral nasal wall of the fornix was performed to remove the nasal dome surface mucosa. An incision of ~10–12 mm height with 45° of sphenoid sinus rongeur was made to completely remove the agger nasi posterior wall, a top wall and frontal surface. A resection of the frontal process of the upper maxilla to lamina papyracea plane was performed. To reach the anterior ethmoidal artery a 15-mm incision was made from the front to the back up to the middle turbinate before the attachment part. Subsequently, resection of the bottom wall of a frontal sinus of the middle turbinate and medial attachment up to the ostium of the frontal sinus medial to the nasal septum was performed. To expose the top and anterior walls of the frontal sinus, a section of the frontal ridges was ground using a frontal drill (1883672HS, Medtronic, Minneapolis, MN, USA). Frontal sinus lesions are shown clearly in Fig. 2. Fully open ostium of the frontal sinus is shown in Fig. 3. For the intraoperative treatment of frontal sinus inverted papilloma, drill grinding was employed with the exception of basal tumor bone and electric coagulation of the root. Hemostatic and anti-adhesive material were utilized as a rapid link.


Endoscopic agger nasi type Draf IIb treatment for frontal sinus lesions
Postoperative endoscopic view of removed inverted papilloma for frontal sinus.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f3-etm-0-0-3467: Postoperative endoscopic view of removed inverted papilloma for frontal sinus.
Mentions: The operation was performed under general anesthesia. A 0° nasal endoscope (7230AA, Karl Storz, Tuttlingen, Germany) with conventional surgical resection and uncinate process between the middle turbinate and lateral nasal wall of the fornix was performed to remove the nasal dome surface mucosa. An incision of ~10–12 mm height with 45° of sphenoid sinus rongeur was made to completely remove the agger nasi posterior wall, a top wall and frontal surface. A resection of the frontal process of the upper maxilla to lamina papyracea plane was performed. To reach the anterior ethmoidal artery a 15-mm incision was made from the front to the back up to the middle turbinate before the attachment part. Subsequently, resection of the bottom wall of a frontal sinus of the middle turbinate and medial attachment up to the ostium of the frontal sinus medial to the nasal septum was performed. To expose the top and anterior walls of the frontal sinus, a section of the frontal ridges was ground using a frontal drill (1883672HS, Medtronic, Minneapolis, MN, USA). Frontal sinus lesions are shown clearly in Fig. 2. Fully open ostium of the frontal sinus is shown in Fig. 3. For the intraoperative treatment of frontal sinus inverted papilloma, drill grinding was employed with the exception of basal tumor bone and electric coagulation of the root. Hemostatic and anti-adhesive material were utilized as a rapid link.

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