Endoscopic frontal sinus drillout in 100 patients.
OBJECTIVE
To determine the efficacy of frontal sinus drillout surgery for the treatment of chronic frontal sinusitis.


METHODS
Retrospective case-control study. Mean +/- SD follow-up was 4.1 +/- 1.53 years (range, 1.4-6.9 years).


METHODS
Academic medical center.


METHODS
One hundred consecutive patients with chronic sinusitis who underwent frontal sinus drillout surgery. Indications were failed previous frontal sinusotomy (n = 88) and frontal sinus mucocele (n = 12).


METHODS
Endoscopic removal of the floor of the frontal sinus (unilateral, n = 34; bilateral, n = 66) with a surgical drill. An intraoperative image-guidance system was used in 65 patients.


METHODS
Frontal sinus patency and improvement of symptoms associated with frontal sinusitis.


RESULTS
Frontal sinus patency with control of symptoms was achieved in 80% of patients. There were no intraoperative complications. Postoperative epistaxis occurred in 4% of patients. Of the 20 patients who developed restenosis of the frontal sinus ostium, 11 underwent revision frontal sinus drillout and 9 proceeded to frontal sinus obliteration. The success rate was comparable for the image-guidance and non-image-guidance groups (83.1% vs 74.3%, respectively; P =.56).


CONCLUSIONS
Frontal sinus drillout performed with or without an image-guidance system appears to be a safe and effective surgery for the treatment of patients with advanced disease of the frontal sinus. This procedure provides a reasonable alternative to frontal sinus obliteration, which remains a treatment option for patients who fail frontal drillout.
Samaha
Mark
M
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Mass, USA.
Cosenza
Mathew J
MJ
Metson
Ralph
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002908:Chronic Disease; D004724:Endoscopy / Q000379:methods*; D005260:Female; D015522:Frontal Sinusitis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome