title: Minitrephination as an adjunctive measure in the endoscopic management of complex frontal sinus disease.
abstract: BACKGROUND
  Frontal sinus disease and its surgical management continues to remain an area of controversy among rhinologists. This is evidenced by the multitude of surgical procedures, both external and endoscopic, that have been developed in its management. This study was performed to evaluate the safety and efficacy of frontal sinus minitrephination in combination with endoscopic frontal sinus exploration for the management of complex frontal sinus disease.
  
  
  METHODS
  A retrospective chart review identified 13 patients treated with minitrephination, in conjunction with endoscopic frontal sinus exploration, at the University of California at Los Angeles Medical Center or West Los Angeles VA Medical Center from July 2004 to October 2005.
  
  
  RESULTS
  Thirteen patients with diagnoses of chronic sinusitis (n = 10), nasal polyposis (n = 7), frontal mucocele (n = 4), allergic fungal sinusitis (n = 3), and inverting papilloma (n = 1) underwent either unilateral (n = 9) or bilateral (n = 4) minitrephination during primary or revision functional endoscopic sinus surgery. Median follow-up was 14.2 months. There were no complications attributed to the procedure, and all patients had improvement of their sinus symptoms and displayed no evidence of recurrence of their frontal sinus disease at last follow-up.
  
  
  CONCLUSIONS
  Minitrephination is a safe and effective adjunct in the management of complex frontal sinus disease, as it allows identification of the frontal recess and vigorous irrigation of the sinus contents.
authors.affiliation: Division of Head and Neck Surgery, Department of Surgery, David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, California 90095-1624, USA.
authors.forename: Alen N
authors.initials: AN
authors.lastname: Cohen
authors.forename: Marilene B
authors.initials: MB
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005624:Frontal Bone / Q000601:surgery*; D005626:Frontal Sinus / Q000601:surgery*; D015522:Frontal Sinusitis / Q000601:surgery* / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000601:surgery / Q000628:therapy; D013517:Otorhinolaryngologic Surgical Procedures; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014207:Trephining