The Draf III septal flap technique: a preliminary report

Am J Otolaryngol. 2013 Sep-Oct;34(5):399-402. doi: 10.1016/j.amjoto.2013.01.019. Epub 2013 Feb 26.

Abstract

Aim: The most prevalent complication of Draf III surgery is recurrence of frontal recess stenosis. The aim of this study is to introduce a method to prevent closure of the recess.

Type of the study and setting: This is a retrospective study that was conducted in Ear, Nose and Throat Referral Center, Amir'Alam Hospital, Tehran.

Methods and materials: We introduced a new technique for reconstructing frontal recess mucosa and prevention of restenosis following Draf III operation; we covered the posterior wall of the common recess with a vascular mucosal flap from nasal septum.

Results: During a 6-month period we used septal flaps based on anterior ethmoidal artery on four patients who had undergone endoscopic Draf III operation. During a 3-month follow-up period, frontal recess stenosis did recur in any of the patients.

Conclusion: Applying a precise and astute surgical method along with reconstructing common recess mucosa will improve the outcomes of endoscopic frontal sinus drill-out. We strongly recommend application of septal mucosal flap based on the anterior ethmoidal artery during Draf III operation to decrease the incidence of scar and recurrence of common frontal recess stenosis.

MeSH terms

  • Constriction, Pathologic
  • Endoscopy / methods*
  • Follow-Up Studies
  • Frontal Sinus / surgery*
  • Humans
  • Nasal Mucosa / transplantation*
  • Nasal Septum / surgery*
  • Paranasal Sinus Diseases / surgery*
  • Retrospective Studies
  • Surgical Flaps*
  • Treatment Outcome