title: Value of septoturbinal flap in the frontal sinus drill-out type IIb according to draf.
abstract: The Draf IIb aims at widening the frontal sinus drainage in a minimally invasive fashion. However, this technique is associated with a high stenosis rate. Hence, local nasal flaps have been recently introduced or designed to speed up mucosal healing and prevent scarring.
  
  
  
  The objective of this study was to present the septoturbinal flap (STF), its use in a Draf IIb, and to examine postoperative outcomes of this procedure.
  
  
  
  From an initial pool of 48 patients with frontal sinus disease to be treated with a Draf IIb, we prospectively selected 46 (95.84%) patients, submitted to a Draf IIb with STF in two Institutions, from November 2010 to November 2014. We excluded two cases (4.16%) for which a flap could not be performed for anatomic restrictions. We present the STF technique and describe demographic data, indication for surgery, and surgery type.
  
  
  
  Indications for surgery included 24 (52.17%) mucoceles or mucopyoceles, 12 (26.1%) chronic rhinosinusitis, four (8.7%) osteomas, two (4.35%) meningoencephaloceles, and four (8.7%) inverted papillomas. Difficult anatomic conditions were encountered in half of the patients. Restenosis of the frontal sinus drainage pathway occurred in one (2.17%) patient. Far-seated frontal mucoceles recurred in two cases (4.35%), with frontal drainage pathway remaining patent. Rescue treatment comprised a Draf III in two cases and one frontal sinus obliteration. Outcome was favorable for 43 (93.5%) patients.
  
  
  
  The use of STF was associated with a high rate of success for a Draf IIb.
  
  
  
  4. Laryngoscope, 126:2428-2432, 2016.
authors.affiliation: Department of Medical and Surgical Pathology, Otorhinolaryngology Unit, Pisa University Hospital, Pisa, Italy. francescaromanafiorini@gmail.com.
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: Fiorini
authors.affiliation: ENT Department, University Hospitals of Leicester, Leicester, United Kingdom.
authors.forename: Claudia
authors.initials: C
authors.lastname: Nogueira
authors.affiliation: Department of Otorhinolaryngology, Lariboisière Hospital, Paris, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Verillaud
authors.affiliation: ENT Department, Nottingham University Hospital, Nottingham, United Kingdom.
authors.forename: Anshul
authors.initials: A
authors.lastname: Sama
authors.affiliation: Department of Otorhinolaryngology, Lariboisière Hospital, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Herman
mesh_terms: D005240:Feasibility Studies; D005260:Female; D005626:Frontal Sinus / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000637:transplantation; D010254:Paranasal Sinus Diseases / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome; D014420:Turbinates / Q000637:transplantation
keywords: Draf III; Draf IIb procedure; Frontal sinusotomy; septoturbinal flap