title: Osteoplastic flap for frontal sinus obliteration in the era of image-guided endoscopic sinus surgery.
abstract: BACKGROUND
  This study evaluates the management of frontal sinus disease using osteoplastic flap surgery (OPFS) in the current era of image-guided endoscopic sinus surgery (IGESS).
  
  
  METHODS
  A retrospective chart review was performed of patients who underwent OPFS and imaged-guided endoscopic frontal sintus surgery in the past 10 years at a tertiary care teaching hospital.
  
  
  METHODS
  Chart reviews of clinic patients and inpatients who underwent OPFS were performed. Indications for surgery, prior sinus surgeries, time to OPFS, post-OPFS sinus surgeries, and associated comorbid factors were reviewed.
  
  
  RESULTS
  In the period under review, 710 IGESS cases were performed. Thirty patients, who were candidates for OPFS, underwent IGESS for frontoethmoid disease. Fourteen patients from this group failed IGESS and underwent OPFS. The indications for OPFS included mucocele in 10 cases, tumors in 2 cases, and trauma in 2 cases. Four patients underwent revision OPFS. The patients who failed IGESS had prior trauma, tumor resection, radiation, or large septate frontal sinus with lateral extension in which the mucocele could not be drained endoscopically. The average time to OPFS was 6.2 years (0-27 years). Nine patients had prior sinus surgery (1-7 prior surgeries) and five patients had subsequent endoscopic surgical procedures.
  
  
  CONCLUSIONS
  In all patients with frontal mucocele, surgery should be attempted endoscopically using IGESS because of the low morbidity of the procedure. Patients with risk factors for failure should be considered for OPFS if IGESS proves to be unsuccessful.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, New York-Presbyterian, University Hospitals of Columbia and Cornell, New York, New York, USA.
authors.forename: Vijay K
authors.initials: VK
authors.lastname: Anand
authors.forename: David H
authors.initials: DH
authors.lastname: Hiltzik
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Kacker
authors.forename: Carlo
authors.initials: C
authors.lastname: Honrado
mesh_terms: D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005626:Frontal Sinus / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009078:Mucocele / Q000601:surgery; D009295:Nasal Bone / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D013524:Surgical Flaps