Endoscopic sinus surgery rescue of failed osteoplastic flap with fat obliteration.
OBJECTIVE
The modified endoscopic Lothrop procedure has been used as an alternative to osteoplastic flap with obliteration in the management of chronic frontal sinusitis. More recently it has been used to rescue cases of failed osteoplastic flap. This article reviews the recent literature regarding endoscopic rescue of failed osteoplastic flap with obliteration.


RESULTS
Endoscopic sinus surgery is indicated in cases of osteoplastic flap failure when there is objective evidence of mucocele formation. All patients require CT and MR imaging preoperatively. Clinical improvement can be achieved in up to 89% of patients in the first 12 to 18 months postoperatively.


CONCLUSIONS
The modified endoscopic Lothrop procedure is effective in the management of failed osteoplastic flap with obliteration in the short term. Long-term evaluation of this technique is still required. Endoscopic rescue is technically challenging and requires an experienced surgeon, ideally with access to image guidance equipment.
Langton-Hewer
Claire D
CD
Department of Surgery-Otolaryngology, Head and Neck Surgery, The University of Adelaide and Flinders University, Adelaide, South Australia.
Wormald
P J
PJ
D002908:Chronic Disease; D004724:Endoscopy / Q000379:methods*; D015522:Frontal Sinusitis / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D015641:Radiography, Interventional; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed