Presented at the Otolaryngology Society Combined Meeting, Phoenix, Arizona, U.S.A., May 28–31, 2009.
Looking around the corner: A review of the past 100 years of frontal sinusitis treatment†
Version of Record online: 28 AUG 2009
Copyright © 2009 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 119, Issue 12, pages 2293–2298, December 2009
How to Cite
Close, L. G. and Stewart, M. G. (2009), Looking around the corner: A review of the past 100 years of frontal sinusitis treatment. The Laryngoscope, 119: 2293–2298. doi: 10.1002/lary.20632
- Issue online: 20 NOV 2009
- Version of Record online: 28 AUG 2009
- Manuscript Accepted: 16 JUN 2009
- Manuscript Received: 4 JUN 2009
- Frontal sinus outflow tract;
- endoscopic surgery;
- outcomes assessment
Over the past 100 years, developments in imaging studies, endoscopic evaluation, medical treatment, and surgical techniques, particularly those employing endoscopic approaches, have led to improvements in our ability to treat frontal sinusitis. Providing “around the corner” views of the frontal recess, 30° and 45° endoscopes have allowed the meticulous preservation of the mucoperiosteum and restoration of normal sinus physiology, even in difficult areas of the frontal sinus outflow tract. Rarely is it necessary to perform radical or obliterative frontal sinus procedures, although the osteoplastic flap obliteration approach advocated by Montgomery continues to be the gold standard for treatment of frontal sinusitis, which has failed medical treatment and endoscopic approaches, at least in the minds of many prominent surgeons. The endoscopic modification of Lothrop's approach has gained favor in the experience of many, however, despite its technical difficulty and failure rate of up to 20%. Technical advances, such as computer-assisted endoscopic surgery and, more recently, intraoperative imaging have shown promise and may lead to further improvement in treatment outcomes. Finally, we will all benefit from further advances in outcomes assessment, which will provide better scientific proof of our clinical observations. Laryngoscope, 2009