Clinical outcome of endoscopic surgery for frontal sinusitis.
OBJECTIVE
To determine the efficacy of endoscopic surgery for chronic frontal sinusitis.


METHODS
A prospective analysis of established measures of clinical outcome (Chronic Sinusitis Survey and Short Form 36) that was administered to patients before frontal sinus surgery and at intervals of 3 months, 6 months, and 1 year after surgery.


METHODS
For limited disease, the frontal recess was opened and the frontal ostium probed or enlarged. For more severe cases, a drill was used to resect the frontal sinus floor and interfrontal septum.


METHODS
Private and institutional-based practices at an academic medical center.


METHODS
Eighty-seven patients who underwent endoscopic surgery for frontal sinusitis, including 24 patients with severe disease who underwent a frontal sinus drillout procedure.


METHODS
Scores on the Chronic Sinusitis Survey, Short Form 36, and surgical revision rate.


RESULTS
Significant improvement in facial pain, nasal drainage, and congestion was observed 1 year after surgery (P<.01). Medication use was also significantly reduced during this period (P<.01). Quality-of-life measures showed greatest improvement in the domain of social functioning (P<.05). Three (12.5%) of 24 patients who underwent a frontal sinus drillout procedure did not respond to surgery secondary to restenosis of the frontal ostium.


CONCLUSIONS
Although the long-term results of endoscopic surgery for frontal sinusitis are unknown, this approach appears to be effective for most patients and may provide a reasonable alternative to frontal sinus obliteration surgery in selected cases.
Department of Otology and Laryngology, Harvard Medical School, Boston, Mass, USA.
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R
Metson
R E
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Gliklich
D000293:Adolescent; D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005626:Frontal Sinus / Q000000981:diagnostic imaging / Q000601:surgery; D015522:Frontal Sinusitis / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome