The ultimate success or failure of frontal sinus surgical procedures, whether they be endonasal or external, is determined essentially by the rate of restenosis of the frontal sinus outflow tract or neo-ostium postoperatively. Long-term stenting for a period of several months significantly reduces the rate of restenosis, particularly in difficult cases. We retrospectively reviewed the cases of 12 patients who received 21 frontal nasal stents, which were left in place for 6 months. Based on outcomes measures that included endoscopy or radiologic findings and patients’ self-evaluations, we conclude that frontal nasal stents that are left in place for 6 months are more effective than stents that are removed earlier. We recommend that this type of management be considered in difficult revision cases and before performing an external operation.
References
1.
CloseL.G., LeeN.K., LeachJ.L., ManningS.C.Endoscopic resection of the intranasal frontal sinus floor. Ann Otol Rhinol Laryngol1994; 103: 952–8.
2.
DrafW.Endonasal micro-endoscopic frontal sinus surgery, the Fulda concept. Op Tech Otolaryngol Head Neck Surg1991; 2: 234–40.
3.
DrafW.Weber R. Endonasal micro-endoscopic pansinusoperation in chronic sinusitis. I. Indications and operation technique. Am J Otolaryngol1993; 14: 394–8.
4.
DrafW., WeberR., KeerlR., ConstantinidisJ.[Current aspects of frontal sinus surgery. I: Endonasal frontal sinus drainage in inflammatory diseases of the paranasal sinuses]. HNO1995; 43: 352–7.
5.
GrossC.W., GrossW.E., BeckerD.G.Modified transnasal endoscopic Lothrop procedure: Frontal drillout. Op Tech Otolaryngol Head Neck Surg1995; 6: 193–200.
JacobsJ.B.100 years of frontal sinus surgery. Laryngoscope1997; 107: 1–36.
9.
HosemannW., KuhnelT., HeldP.Endonasal frontal sinusotomy in surgical management of chronic sinusitis: A critical evaluation. Am J Rhinol1997; 11: 1–19.
10.
MayM., SchaitkinB.Frontal sinus surgery: Endonasal drainage instead of an external osteoplastic approach. Op Tech Otolaryngol Head Neck Surg1995; 6: 184–92.
11.
MetsonR.Endoscopic treatment of frontal sinusitis. Laryngoscope1992; 102: 712–6.
12.
SchaeferS.D., CloseL.G.Endoscopic management of frontal sinus disease. Laryngoscope1990; 100: 155–60.
WigandM.E., HosemannW.G.Endoscopic sinus surgery for frontal sinusitis and its complications. Am J Rhinol1991; 5: 85–9.
15.
KuhnF.A., BolgerW.E., TisdahlR.G.The agger nasi cell in frontal recess obstruction: An anatomic, radiologic and clinical correlation. Op Tech Otolaryngol Head Neck Surg1991; 2: 226–31.
16.
StammbergerH.Endoscopic diagnosis and surgery of the paranasal sinuses and anterior skull base—the Messerklinger technique and advanced applications from the Graz school.Tuttlingen, Germany: Storz GmbH.
17.
GoodaleR.L., MontgomeryW.W.Anterior osteoplastic frontal sinus operation. Five years’ experience. Ann Otol1961; 70: 860–80.
WeberR., DrafW., KahleG., KindM.Obliteration of the frontal sinus—state of the art and reflections on new materials. Rhinology1999; 37: 1–15.
20.
WeberR., HosemannW.Draf W, et al. [Endonasal frontal sinus surgery with permanent implantation of a place holder]. Laryngorhinootologie1997; 76: 728–34.
21.
ShikaniA.H.A new middle meatal antrostomy stent for functional endoscopic sinus surgery. Laryngoscope1994; 104: 638–41.
22.
ToffelP.H.Secure endoscopic sinus surgery with middle meatal stenting. Op Tech Otolaryngol Head Neck Surg1995; 6: 157–62.
23.
AmbleF.R., KernE.B., NeelB3dNasofrontal duct reconstruction with silicone rubber sheeting for inflammatory frontal sinus disease: Analysis of 164 cases. Laryngoscope1996; 106: 809–15.
24.
NeelH.B., WhickerJ.H., LakeC.F.Thin rubber sheeting in frontal sinus surgery: Animal and clinical studies. Laryngoscope1976; 86: 524–36.
25.
NeelH.B.3rd, McDonaldT.J., FacerG.W.Modified Lynch procedure for chronic frontal sinus diseases: Rationale, technique, and long-term results. Laryngoscope1987; 97: 1274–9.
26.
StammbergerH.[Complications of inflammatory paranasal sinus diseases including iatrogenically-induced complications]. Eur Arch Otorhinolaryngol Suppl1993; 1: 61–102.
27.
HoytW.H.3rdEndoscopic stenting of nasofrontal communication in frontal sinus disease. Ear Nose Throat J1993; 72: 596–7.
28.
ClarkR.A., HensonP.M.The Molecular and Cellular Biology of Wound Repair.New York: Plenum Press, 1988.
HosemannW., WigandM.E., GodeU.Normal wound healing of the paranasal sinuses: Clinical and experimental investigations. Eur Arch Otorhinolaryngol1991; 248: 390–4.
31.
WeberR., KeerlR., HuppmannA.Investigation of wound healing after paranasal sinus surgery with time lapse video—first results. Am J Rhinol1996; 10: 235–8.
32.
WeberR., KeerlR., JaspersenD.Computer-assisted documentation and analysis of wound healing of the nasal and oesophageal mucosa. J Laryngol Otol1996; 110: 1017–21.
