title: Modified hemi-Lothrop procedure for supraorbital frontal sinus access: a cadaveric feasibility study.
abstract: OBJECTIVE
  The endoscopic modified Lothrop procedure (EMLP) is a relatively safe and efficacious advanced approach to access the frontal sinus for recalcitrant disease. There have been limited data specifically addressing those patients with advanced but unilaterally limited and supraorbitally based frontal sinus disease. In this study, the authors propose a modification of the EMLP technique, titled a modified hemi-Lothrop procedure (MHLP), which would limit the dissection of the EMLP to removal of the frontal sinus floor of the unilaterally diseased frontal sinus, thereby sparing the mucosa and natural drainage pathways of the nondiseased contralateral frontal sinus.
  
  
  METHODS
  Cadaveric study at an academic medical center.
  
  
  METHODS
  A cadaveric dissection with photodocumentation was performed to demonstrate the MHLP and to quantify the accessibility of this approach to far-laterally based frontal sinus disease.
  
  
  RESULTS
  The MHLP dissection was shown to provide adequate access to the most distal supraorbital and laterally based aspects of the frontal sinus. Using 3 cadavers, the authors demonstrated and documented the technique of MHLP to access lateral frontal sinus disease from the contralateral nasal cavity via a superior septectomy window.
  
  
  CONCLUSIONS
  The MHLP was demonstrated to be a feasible approach and alternative to more traditional endoscopic procedures in addressing unilateral frontal sinus disease. This modification may be useful in addressing difficult to access unilateral disease that may otherwise require more extensive resection. This demonstration helps define the accessibility of the lateral frontal sinus via an MHLP and begins to provide estimates of which patients may benefit from this approach.
authors.affiliation: Department of Otolaryngology, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA. jean.anderson.eloy@gmail.com
authors.forename: Jean Anderson
authors.initials: JA
authors.lastname: Eloy
authors.forename: Mark E
authors.initials: ME
authors.lastname: Friedel
authors.forename: Kim P
authors.initials: KP
authors.lastname: Murray
authors.forename: James K
authors.initials: JK
authors.lastname: Liu
mesh_terms: D002102:Cadaver; D004210:Dissection; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D005626:Frontal Sinus / Q000601:surgery*; D015522:Frontal Sinusitis / Q000601:surgery; D006801:Humans; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*