title: Outside-In Frontal Drill-Out: How I Do It.
abstract: BACKGROUND
  The Draf 3 frontal sinusotomy, or modified Lothrop procedure has been used to treat recalcitrant rhinosinusitis, frontal sinus mucocoeles or to provide access for cerebrospinal fluid leaks, frontoethmoid fractures, frontal sinus tumors and skull base tumors.
  
  
  OBJECTIVE
  To describe authors approach to the "Outside-In Frontal Drill-Out".
  
  
  METHODS
  Descriptive.
  
  
  RESULTS
  The "Outside-In" frontal drill-out is an approach that emphasizes the early identification of the first olfactory neuron, maximization of bone removal, and preservation of the posterior table mucosa.
  
  
  CONCLUSIONS
  The advantages of this approach are it provides unobstructed view and identifies anatomic limits early, bone removal is fast and efficient; it is safe, and it is a robust technique based upon fixed anatomic landmarks.
authors.affiliation: Division of Rhinology and Skull Base Surgery, St Vincent's Hospital, Sydney, Australia.
authors.forename: Anna
authors.initials: A
authors.lastname: Knisely
authors.forename: Henry P
authors.initials: HP
authors.lastname: Barham
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Harvey
authors.forename: Raymond
authors.initials: R
authors.lastname: Sacks
mesh_terms: D004724:Endoscopy / Q000379:methods*; D005626:Frontal Sinus / Q000601:surgery*; D015522:Frontal Sinusitis / Q000601:surgery*; D006801:Humans; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*