title: Revision endoscopic frontal sinus surgery with surgical navigation.
abstract: BACKGROUND
  Revision surgery of the frontal sinus remains one of the most difficult operations for the endoscopic surgeon. Most agree that knowledge and recognition of its complex anatomy and sparing of frontal recess mucosa are keys to a successful operation. The use of surgical navigation systems may allow for more precise dissections and greater rates of frontal recess patency.
  
  
  METHODS
  Retrospective review of all patients undergoing revision endoscopic frontal sinus surgery with surgical navigation was performed with a minimum 24-month follow-up.
  
  
  RESULTS
  Sixty-seven patients underwent revision endoscopic frontal sinus surgery with surgical navigation. The average follow-up was 32 months. Fifty-eight (86.6%) had a patent frontal recess and significant subjective improvement in symptoms. No patient underwent external frontal sinus obliteration, and there were no major complications.
  
  
  CONCLUSIONS
  Endoscopic techniques with surgical navigation are effective in revision frontal sinus cases. The dissection of remnant agger nasi, obstructing frontal and supraorbital cells are necessary to widen the anterior-posterior as well as the medial-lateral dimensions of the recess. Computer navigational systems appear to serve as a valuable adjunct in preoperative planning and safe intraoperative dissection.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, CA 94305, USA.
authors.forename: Alexander G
authors.initials: AG
authors.lastname: Chiu
authors.forename: Winston C
authors.initials: WC
authors.lastname: Vaughan
mesh_terms: D004724:Endoscopy / Q000379:methods*; D005626:Frontal Sinus / Q000601:surgery*; D015522:Frontal Sinusitis / Q000601:surgery*; D006801:Humans; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D013238:Stereotaxic Techniques; D016896:Treatment Outcome