title: Surgical outcomes following the endoscopic modified Lothrop procedure.
abstract: OBJECTIVE
  We performed a systematic review of 97 patients in whom an entirely endoscopic modified Lothrop procedure (EMLP) was performed. We studied the safety, efficacy, need for revision surgery, and rate of complication following an EMLP.
  
  
  METHODS
  The study design was a retrospective chart analysis.
  
  
  METHODS
  We performed a retrospective chart review and patient survey of 97 patients who underwent an EMLP at our institution from January 1999 to March 2006. Main outcomes measured were the need for revision surgery including an osteoplastic flap (OPF), improvement in patients' symptoms, and rate of cerebrospinal fluid (CSF) leak.
  
  
  RESULTS
  The most common indication for the procedure was chronic frontal sinusitis and/or formation of mucocele. The frontal recess and floor of the frontal sinus were the most common areas of persistent disease. CSF leak rate was 1% (1/97) and was managed successfully at the time of surgery without any long-term sequelae. Twenty-two (23%) patients required revision surgery. Three (3%) patients required revision with an OPF. Some degree of symptomatic clinical improvement was reported by 98% (95/97) of patients.
  
  
  CONCLUSIONS
  EMLP is a safe and effective surgical alternative to OPF for patients with recalcitrant frontal sinus disease. Major complications are rare. A large percentage of patients may require revision surgery.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois, USA.
authors.forename: Mobeen A
authors.initials: MA
authors.lastname: Shirazi
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Silver
authors.forename: James A
authors.initials: JA
authors.lastname: Stankiewicz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D015522:Frontal Sinusitis / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009078:Mucocele / Q000601:surgery; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D013238:Stereotaxic Techniques; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome