Abstract
The selection of the surgical approach to the frontal sinus should be personalized. The selected technique should be tailored to address the disease effectively while minimizing the risks of complications and postoperative sequelae. Factors that determine the choice of approach include the location, extent, and pathology of the disease, the variants of frontal sinus anatomy, the surgeon’s level of expertise, and the availability of frontal-specific instrumentation. These determinants have been discussed in previous chapters. In the modern era, endoscopic techniques have supplanted most external techniques. However, external techniques remain relevant and at times invaluable for specific pathologies. Additionally, the supplementary use of certain external techniques such as the frontal trephination may facilitate effective, safe, and efficient endoscopic surgery. In the contemporary era, a function-restoring philosophy (“functional external sinus surgery”) can be applied to many patients that historically might have been obliterated. Obliteration and cranialization of the frontal sinus remain useful techniques but are usually necessary only for rare indications.
This concluding chapter will detail the editors’ philosophical approach to the selection of technique for frontal sinus surgery. This chapter will highlight anatomical and pathological considerations that dictate choices using illustrative cases and videos.
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Draf IIB procedure for severe inflammation, friable mucosa, osteitis with stenting (WMV 20787 kb)
Draf IIB for lateralized right middle turbinate stub (WMV 67842 kb)
Draf III (primary) for neo-osteogenesis in a patient with extensive neo-osteogenesis of the frontal recess (MPG 149120 kb)
Allergic fungal sinusitis months post-op after a Draf IIA procedure (WMV 3661 kb)
Draf IIB for inverted papilloma of the right frontal sinus (WMV 80854 kb)
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Lal, D., Hwang, P.H. (2019). Frontal Sinus Surgery: Selection of Technique. In: Lal, D., Hwang, P. (eds) Frontal Sinus Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-97022-6_30
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DOI: https://doi.org/10.1007/978-3-319-97022-6_30
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