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Endoscopic and Microscopic Revision Frontal Sinus Surgery

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Revision Sinus Surgery

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Abstract

• There must be a reasonable correlation between a patient’s complaints and radiologic findings.

• High-resolution computed tomography and magnetic resonance imaging are the most valid imaging modalities.

• Revision surgery is most often necessary due to incomplete removal of obstructing agger nasi cells, superior attachment of the ethmoid bulla or uncinate process (incomplete anterior ethmoidectomy), lateralization of middle-turbinate remnants, neoosteogenesis of the frontal recess, and polypoid mucosa obscuring the recess.

• Endonasal revision frontal sinus surgery requires detailed anatomical knowledge.

• In the majority of patients revision can be managed successfully via the endonasal route by performing Draf ’s type I–III drainages.

• In aspirin triad, patients with severe polyposis, Draf ’s type III drainage is indicated as the first revision procedure.

• Contraindications for endonasal frontal sinus revision surgery are anterior–posterior dimension less than 0.5 cm, inadequate surgical training, and lack of proper instrumentation.

• The external osteoplastic, mostly obliterative frontal sinus operation must be part of the armamentarium of the experienced sinus surgeon for the resolution of exceptionally difficult frontal sinus problems.

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Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology – Head, University Hospital Gießen, Klinikstraße 29, 35392, Gießen, Hessen, Germany

    Ulrike Bockmühl

  2. ENT Department, INI International Neuroscience Institute, Rudolf-Pichlmayr-Straße 4, 30625, Hannover, Niedersachsen, Germany

    Wolfgang Draf

Authors
  1. Ulrike Bockmühl
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  2. Wolfgang Draf
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© 2008 Springer-Verlag Berlin Heidelberg

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Bockmühl, U., Draf, W. (2008). Endoscopic and Microscopic Revision Frontal Sinus Surgery. In: Revision Sinus Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-78931-4_14

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  • DOI: https://doi.org/10.1007/978-3-540-78931-4_14

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-78930-7

  • Online ISBN: 978-3-540-78931-4

  • eBook Packages: MedicineMedicine (R0)

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