Initial surgical treatment for chronic frontal sinusitis: a pilot study

Ann Otol Rhinol Laryngol. 2007 Apr;116(4):286-9. doi: 10.1177/000348940711600412.

Abstract

Objectives: The initial surgical treatment for chronic frontal sinusitis is not well defined. Our objective was to determine the effectiveness of anterior ethmoidectomy for chronic frontal sinusitis.

Methods: Patients with chronic frontal sinusitis who underwent anterior ethmoidectomy as initial surgical treatment were reviewed. Data were collected from computed tomography scans with use of the Lund-Mackay scale. Data on demographics, comorbidities, management, postoperative recovery, and follow-up were collected.

Results: Seventy-seven patients representing 121 diseased frontal sinuses met the inclusion criteria. The respiratory comorbidities were asthma alone (8.3%), asthma and polyps (6.6%), aspirin triad (5.8%), and cystic fibrosis (0.8%). Nineteen of 121 frontal sinuses (15.7%) belonged to smokers. Fourteen of 121 frontal sinuses (11.5%) exhibited postoperative evidence of disease. Of these 14 frontal sinuses, 10 (8.3%) underwent revision surgery. Frontal sinuses of patients with aspirin triad, with both nasal polyposis and asthma, or with inter-frontal sinus septal cells were more likely to fail Draf I surgery (p < .05).

Conclusions: Anterior ethmoidectomy for drainage of frontal sinuses appears to be effective initial surgical treatment for chronic frontal sinusitis. Patients with aspirin triad, both asthma and polyposis, or inter-frontal sinus septal cells are more likely to fail this procedure.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Chronic Disease
  • Endoscopy*
  • Ethmoid Bone / surgery
  • Female
  • Follow-Up Studies
  • Frontal Sinusitis / diagnostic imaging
  • Frontal Sinusitis / surgery*
  • Humans
  • Male
  • Middle Aged
  • Otorhinolaryngologic Surgical Procedures / methods*
  • Pilot Projects
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome