Endoscopic modified Lothrop procedure for the treatment of chronic frontal sinusitis: a systematic review

Abstract

The evidence base for EMLP was deemed inadequate to assess its safety and efficacy, and an audit of the procedure was recommended. Additional clinical recommendations were made regarding the development and current practice of EMLP during this audit phase.

The frontal osteoplastic flap: does it still have a place in rhinological surgery?

“…9 However, these rates were for a small series of patients ranging in age from nine to 20 years. More recently, Shirazi et al To stent or not to stent Maintaining nasofrontal patency can be problematic following the endoscopic modified Lothrop procedure.…”

“…A thorough knowledge of frontal sinus anatomy and proper training are required, even with the assistance of intra-operative image guidance. 9,10 Frontal osteoplastic flap versus modified Lothrop procedure As the endoscopic modified Lothrop procedure is usually performed on an out-patient basis, it is generally cheaper than treatment requiring hospital admission. Gross et al reported the cost advantage of the endoscopic modified Lothrop procedure over the frontal osteoplastic flap procedure with obliteration.…”

“…These authors argue that a lower success rate following endoscopic modified Lothrop procedure would be acceptable due to this procedure's reduced morbidity, and that the procedure does not preclude patients from undergoing further surgical procedures, including frontal osteoplastic flap with obliteration. 9,12 The general consensus is that the endoscopic modified Lothrop procedure may not replace the frontal osteoplastic flap with obliteration procedure, but may serve as an intermediate procedure in selected patients for whom FESS is the first option and frontal osteoplastic flap with obliteration the last.…”

Endoscopic Endonasal Approach for Olfactory Groove Meningiomas

“…An extended frontal sinusotomy (modified Lothrop procedure) is performed to expose the anterior extent of the transcribriform corridor. 41 A superior septectomy is performed to provide a panoramic view with binostril access to the ventral cribriform plate. An additional posterior septectomy can be made to allow triangulation of instrumentation through both nostrils to the surgical target.…”

Selecting the Best Approach to the Frontal Sinus

“…However there are centres that would advocate more widespread use of the technique for routine work [5,25]. For cases of CRS, recurrence rates for this technique generally appear to be over 20% [25][26][27], and although some centres have reduced the actual rate of revision surgery, the recurrence rate of chronic frontal sinusitis remains above 20% [5,28]; in this respect the evidence for it to replace the osteoplastic flap as the gold standard is still lacking [29].…”