Long-term stenting for chronic frontal sinus disease: case series and literature review.
OBJECTIVE
The frontal sinus outflow tract consists anatomically of narrow channels prone to stenosis. Following both endonasal and external approach surgery, up to 30 per cent of patients suffer post-operative re-stenosis of the frontal sinus outflow tract, with recurrent frontal sinus disease. This paper proposes the surgical placement of a long-term frontal sinus stent to maintain fronto-nasal patency, as an alternative to more aggressive surgical procedures such as frontal sinus obliteration and modified Lothrop procedures.


METHODS
We present a series of three patients with frontal sinus disease and significant co-morbidity, the latter making extensive surgery a significant health risk. We also review the relevant literature and discuss the use of long-term frontal sinus stenting.


RESULTS
These three cases were successfully treated with long-term frontal sinus stenting. Stents remained in situ for a period ranging from 48 to over 60 months.


CONCLUSIONS
Due to the relatively high failure rates for both endonasal and external frontal sinus surgery, with a high post-operative incidence of frontal sinus outflow tract re-stenosis, long-term stenting is a useful option in carefully selected patients.
Hunter
B
B
Department of Otolaryngology/Head and Neck Surgery, Gloucestershire Royal Hospital, Gloucester, UK. benhunter@doctors.org.uk
Silva
S
S
Youngs
R
R
Saeed
A
A
Varadarajan
V
V
D000368:Aged; D002908:Chronic Disease; D003251:Constriction, Pathologic; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005626:Frontal Sinus / Q000601:surgery*; D015522:Frontal Sinusitis / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D010254:Paranasal Sinus Diseases / Q000209:etiology / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D012008:Recurrence; D015607:Stents; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology