[Endonasal frontal sinus surgery. Part 1: Frontal sinus drainage, types I and II]

Abstract

Endonasal frontal sinus surgery aims to create adequate access to the frontal sinus, remove specific pathologic processes, and establish a permanent and sufficient drainage and ventilation. We present a concept of frontal sinus surgery that depends on the individual anatomy of the frontal and ethmoid sinuses and includes a stepwise intensity of the surgical procedure. Endonasal frontal sinus drainage according to Draf ranges from uncinectomy to the maximal procedure, type III drainage; these procedures are outlined in detail. A comprehensive overview of technical aspects to optimize the operative technique and postoperative results is given. Surgical details include the application of nasal packing, mitomycin C, mucosal transplants, silicone foils or stents, and the new technology of balloon sinuplasty. Specific instrumentation and endoscopic equipment are recommended. Part 1 deals with types I and II frontal sinus drainage. Part 2 explains type III drainage, technical details, and special aspects of postoperative care.