title: Various causes for frontal sinus obstruction.
abstract: OBJECTIVE
  A variety of inflammatory and structural conditions can cause frontal sinusitis. The present study was conducted as pilot study to determine the primary cause of frontal sinusitis at the time of endoscopic sinus surgery.
  
  
  METHODS
  Retrospective chart review was performed from 1997 to 2004 of patients who underwent endoscopic frontal sinus surgery at the University of Virginia. Demographic data, intraoperative frontal recess findings, and history of prior sinus procedures were collected.
  
  
  RESULTS
  There were 102 patients, and 176 endoscopic frontal sinus surgeries were performed with mean follow-up of 29 months. The major causes for frontal sinusitis were polyp (53%), frontal recess synechia (21%), agger nasi cell (12%), and narrow osteomeatal complex (5%). Frontal recess synechia was present only in patients who had prior surgery.
  
  
  CONCLUSIONS
  Inflammatory polyps, followed by synechia, were the most common causes of chronic frontal sinusitis requiring frontal sinus surgery. Further investigation is warranted to identify the sources of frontal recess synechia and to develop preventative strategies of this iatrogenic problem.
authors.affiliation: Division of Rhinology and Endoscopic Sinusand Skull-base Surgery, Department of Otolaryngology and Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, VA 23507, USA. hanjk@evms.edu
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Han
authors.forename: Tamer
authors.initials: T
authors.lastname: Ghanem
authors.forename: Bonmyong
authors.initials: B
authors.lastname: Lee
authors.forename: Charlie W
authors.initials: CW
authors.lastname: Gross
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D015331:Cohort Studies; D004724:Endoscopy; D005260:Female; D005626:Frontal Sinus / Q000473:pathology / Q000601:surgery; D015522:Frontal Sinusitis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D009298:Nasal Polyps / Q000150:complications / Q000473:pathology / Q000601:surgery; D010865:Pilot Projects; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult