Five ‘nontraditional’ techniques for use in patients with recalcitrant sinusitis

Schneider, John S.; Archilla, Alfredo S.; Duncavage, James A.

doi:10.1097/moo.0b013e32835bf65b

Cited by 6 publications

(8 citation statements)

References 29 publications

(25 reference statements)

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“…Subsequent studies have been published reviewing patients who underwent a combined trephination with frontal sinusotomy for complex frontal sinus pathology . However, due to difficulties with endoscopic access to the lateral‐most extent of the sinus, combined with the need for preservation of the frontal sinus outflow tract and minimization of postoperative scarring, there has been continued evolution of technique and instrumentation for access to this area …”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8] However, due to difficulties with endoscopic access to the lateral-most extent of the sinus, combined with the need for preservation of the frontal sinus outflow tract and minimization of postoperative scarring, there has been continued evolution of technique and instrumentation for access to this area. [1][2][3][4][5]10,15,36 Within the era of endoscopic sinus surgery, frontal sinus trephination has remained the most routinely utilized of all external procedures. [1][2][3][4][5]36 Frontal trephination allows surgery to be performed through a small and well-camouflaged external incision without disruption of the frontal sinus outflow tract.…”

Section: Discussionmentioning

confidence: 99%

“…Indications for endoscopic surgical approaches to the frontal sinus have expanded with increasing experience with endoscopic techniques. The frontal trephination technique is a very useful adjunct to reach far lateral and superior disease in frontal sinus surgery, when endoscopic access alone is not sufficient . The use of the combined endoscopic‐trephination approach can potentially supplement the need for a conventional external approach such as the osteoplastic flap technique .…”

Section: Introductionmentioning

confidence: 99%

“…The frontal trephination technique is a very useful adjunct to reach far lateral and superior disease in frontal sinus surgery, when endoscopic access alone is not sufficient. [1][2][3][4] The use of the combined endoscopic-trephination approach can potentially supplement the need for a conventional external approach such as the osteoplastic flap technique. 5,6 Conventionally, surgeons chose between traditional open approaches (osteoplastic flap, frontal trephination) or purely endoscopic approaches (endoscopic frontal sinusotomy, endoscopic modified Lothrop).…”

Section: Introductionmentioning

confidence: 99%

“…5,6 Endoscopic frontal trephination is a useful adjunctive procedure for frontal sinus surgery with minimal morbidity with many contemporary indications. [1][2][3][4][5][6] Our goal was to highlight the versatility of the frontal trephination approach through our case report and through a systematic literature review.…”

Section: Introductionmentioning

confidence: 99%

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Contemporary applications of frontal sinus trephination: A systematic review of the literature

2015

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Our objective was to perform a systematic review of the literature on contemporary indications and outcomes for frontal sinus trephination and present an illustrative case of an endoscopically assisted repair of a subcutaneous frontal sinus fistula by trephination technique. PubMed and Ovid databases were used as data sources. A systematic review of the English literature was completed to review reports of frontal trephination from 1980 to 2014. Articles meeting inclusion criteria for inflammatory and noninflammatory indications were reviewed. Articles were systematically reviewed and graded by evidence-based medicine level. An illustrative case from our institution is then presented. The systematic review identified 2,621 published studies. Thirty-eight studies were identified for inclusion. The indications, techniques, outcomes, safety, and complications were reviewed for noninflammatory and inflammatory conditions. There were 32 retrospective case series, reports, or cohort studies (level 4), four systematic reviews (level 3), one prospective analysis (level 3), and one meta-analysis (level 2). Due to the heterogeneity of study cases and inclusion criteria, a meta-analysis was not feasible. We also present a novel closure of an anterior skull base defect resulting in a subcutaneous fistula with use of a frontal trephination approach. The frontal sinus trephination should not be regarded as a procedure of the past, as it useful in the armamentarium of the modern sinus and skull base surgeon. This approach provides access for instrumentation for hard-to-reach frontal sinus disease either purely through a trephination approach or as a supplementation to the transnasal endoscopic approach. Evidence supporting frontal sinus trephination is of levels 2, 3, and 4. Level of evidence: NA.

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Section: Discussionmentioning

confidence: 99%