Is there a reason for performing frontal sinus trephination at 1 cm from midline? A tomographic study.

Piltcher, Otávio Bejzman; Antunes, Marcelo; Monteiro, Fernanda; Schweiger, Cláudia; Schatkin, Barry

doi:10.1016/s1808-8694(15)30996-4

Cited by 3 publications

(5 citation statements)

References 6 publications

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“…Piltcher et al reviewed 69 CT scans similarly at measurements of 5 mm, 10 mm, and 15 mm from midline. Men presented a frontal sinus significantly larger in the distances of 5 mm and 10 mm when compared to women, but there was no statistical difference in the depth of the sinus at 15 mm . The frontal sinus depth measured at 5 mm of the midline was significantly larger than that at 10 and 15 mm, just as the measure at 10 mm was significantly higher when compared to that at 15 mm (12.22 vs. 11.78 mm, 12.22 mm vs. 10.78 mm, 11.78 mm vs. 10.78 mm) .…”

Section: Resultsmentioning

confidence: 74%

“…Men presented a frontal sinus significantly larger in the distances of 5 mm and 10 mm when compared to women, but there was no statistical difference in the depth of the sinus at 15 mm. 33 The frontal sinus depth measured at 5 mm of the midline was significantly larger than that at 10 and 15 mm, just as the measure at 10 mm was significantly higher when compared to that at 15 mm (12.22 vs. 11.78 mm, 12.22 mm vs. 10.78 mm, 11.78 mm vs. 10.78 mm). 33 In their study, the sinus depth when measured at 5, 10, and 15 mm away from the midline showed statistically significant differences, demonstrating that the closer the proximity to the midline, the deeper it was.…”

Section: Systematic Reviewmentioning

confidence: 81%

“…33 The frontal sinus depth measured at 5 mm of the midline was significantly larger than that at 10 and 15 mm, just as the measure at 10 mm was significantly higher when compared to that at 15 mm (12.22 vs. 11.78 mm, 12.22 mm vs. 10.78 mm, 11.78 mm vs. 10.78 mm). 33 In their study, the sinus depth when measured at 5, 10, and 15 mm away from the midline showed statistically significant differences, demonstrating that the closer the proximity to the midline, the deeper it was. They however concluded that the usual distance of 10 mm from the midline proved to add more advantages for trephination when the risk of crossed trephination at the 5-mm mark and the risk of sinus hypotrophy at 15 mm are considered.…”

Section: Systematic Reviewmentioning

confidence: 81%

“…In their study, the sinus depth when measured at 5, 10, and 15 mm away from the midline showed statistically significant differences, demonstrating that the closer the proximity to the midline, the deeper it was. They however concluded that the usual distance of 10 mm from the midline proved to add more advantages for trephination when the risk of crossed trephination at the 5‐mm mark and the risk of sinus hypotrophy at 15 mm are considered . Pondé et al reviewed 98 CT scans for dimensions and volume.…”

Section: Resultsmentioning

confidence: 99%

“…They however concluded that the usual distance of 10 mm from the midline proved to add more advantages for trephination when the risk of crossed trephination at the 5-mm mark and the risk of sinus hypotrophy at 15 mm are considered. 33 Pond e et al reviewed 98 CT scans for dimensions and volume. The average anteroposterior diameter was 12.01 mm in males and 10.16 mm in females.…”

Section: Systematic Reviewmentioning

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: Resultsmentioning

confidence: 74%

Section: Systematic Reviewmentioning

confidence: 81%

Section: Systematic Reviewmentioning

confidence: 81%

Section: Resultsmentioning

confidence: 99%

Section: Systematic Reviewmentioning

confidence: 99%

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

2015

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Zero‐Degree Endoscopic Visualization of the Frontal Sinus Predicts Improved Topical Irrigation Delivery

et al. 2020

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Objective Management of chronic frontal rhinosinusitis is challenging with high rates of treatment failure, exacerbated by limitations of topical irrigation delivery. We hypothesize that intraoperative zero‐degree visualization of the frontal sinus predicts improved postoperative irrigation penetration. Extending a Draf IIa frontal sinusotomy with a limited resection of the middle turbinate axilla‐agger nasi complex can allow zero‐degree endoscopic visualization of the frontal sinus. This study investigates the change in frontal sinus irrigation delivery after standard Draf IIa frontal sinusotomy versus further resection to achieve zero‐degree visualization. Study Design This is a prospective cohort study conducted in a surgical skills laboratory. Methods The extent of irrigant penetration into the frontal sinuses was evaluated in 10 cadaveric frontal sinuses following Draf IIa sinusotomy using a standardized trephine visualization model. Irrigant penetration was assessed by three blinded reviewers using the following scale: 0 = irrigation restricted to nasal cavity; 1 = irrigation reaches frontal recess; 2 = irrigation reaches frontal sinus proper; 3 = irrigation fills entire frontal sinus. These results were compared to irrigation after achieving zero‐degree endoscopic visualization by performing limited resection of the middle turbinate axilla‐agger nasi complex. Results Irrigant penetration following standard Draf IIa frontal sinusotomy improved after the axilla‐agger nasi complex was resected to achieve zero‐degree endoscopic visualization (median score 2 [interquartile range: 1–2] vs. 3 [interquartile range: 2–3], P < .01). Conclusion This study demonstrates improved penetration of frontal sinus irrigation following limited resection of the middle turbinate axilla‐agger nasi complex to achieve zero‐degree endoscopic visualization of the frontal sinus as compared to standard Draf IIa frontal sinusotomy. Level of Evidence N/A Laryngoscope, 131:250–254, 2021

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Indication of Frontal Sinus Trephination Procedure

Megía

Lobo²,

Viera³

2022

Atlas of Frontal Sinus Surgery

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Is there a reason for performing frontal sinus trephination at 1 cm from midline? A tomographic study.

Abstract: Analyzing the results, the trephination may be performed at variable points of the frontal sinus, but the distance of 1 cm from midline appears to be safer and shows better aesthetic results.

Cited by 3 publications

References 6 publications

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

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

Zero‐Degree Endoscopic Visualization of the Frontal Sinus Predicts Improved Topical Irrigation Delivery

Indication of Frontal Sinus Trephination Procedure

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