title: Initial surgical treatment for chronic frontal sinusitis: a pilot study.
abstract: OBJECTIVE
  The initial surgical treatment for chronic frontal sinusitis is not well defined. Our objective was to determine the effectiveness of anterior ethmoidectomy for chronic frontal sinusitis.
  
  
  METHODS
  Patients with chronic frontal sinusitis who underwent anterior ethmoidectomy as initial surgical treatment were reviewed. Data were collected from computed tomography scans with use of the Lund-Mackay scale. Data on demographics, comorbidities, management, postoperative recovery, and follow-up were collected.
  
  
  RESULTS
  Seventy-seven patients representing 121 diseased frontal sinuses met the inclusion criteria. The respiratory comorbidities were asthma alone (8.3%), asthma and polyps (6.6%), aspirin triad (5.8%), and cystic fibrosis (0.8%). Nineteen of 121 frontal sinuses (15.7%) belonged to smokers. Fourteen of 121 frontal sinuses (11.5%) exhibited postoperative evidence of disease. Of these 14 frontal sinuses, 10 (8.3%) underwent revision surgery. Frontal sinuses of patients with aspirin triad, with both nasal polyposis and asthma, or with inter-frontal sinus septal cells were more likely to fail Draf I surgery (p < .05).
  
  
  CONCLUSIONS
  Anterior ethmoidectomy for drainage of frontal sinuses appears to be effective initial surgical treatment for chronic frontal sinusitis. Patients with aspirin triad, both asthma and polyposis, or inter-frontal sinus septal cells are more likely to fail this procedure.
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, University of Virginia Health System, Charlottesville, USA.
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Becker
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Han
authors.forename: Thuy-Anh
authors.initials: TA
authors.lastname: Nguyen
authors.forename: Charles W
authors.initials: CW
authors.lastname: Gross
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004724:Endoscopy; D005004:Ethmoid Bone / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D015522:Frontal Sinusitis / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010865:Pilot Projects; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome