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Mansour Hajbeygi, Ali Nadjafi, Amin Amali, Babak Saedi, Seyed Mousa Sadrehosseini
INTRODUCTION: The surgical management of chronic frontal sinus disorders remains a challenge for rhinologists. The aim of this study was to evaluate the result of Draf III in a series of patients who underwent this procedure. MATERIALS AND METHODS: Twenty patients were included in this study. Demographic data, history of prior surgery, asthma, aspirin sensitivity and Lund-Mackay score were recorded. A visual analog scale was used for frontal-related symptoms. Patients were followed for a mean duration of 17...
September 2016: Iranian Journal of Otorhinolaryngology
Linggai Shi, Jun Liu, Jiqing Ma, Fei Liu, Guangke Wang
Treatment of frontal sinus using surgery is complicated owing to the complex anatomical structure of the sinus region. The aim of the present study was to investigate the efficacy and safety of Draf IIb endoscopic frontal sinus surgery treatment for frontal sinus lesions using the agger nasi approach on 19 patients (28 left or and right nasal cavities). A 10-12 mm excision of the upper frontal maxilla was performed for endoscopic resection between the middle turbinate and lateral nasal wall. No serious complications in frontal sinus surgery treatment for the removal of the frontal sinus were observed...
September 2016: Experimental and Therapeutic Medicine
Jessica E Southwood, Todd A Loehrl, David M Poetker
In the standard functional endoscopic sinus surgery (FESS) procedure, the amount of dissection is often determined by the extent of disease with the goal to preserve as much normal mucosa as possible while restoring ventilation and reestablishing mucociliary clearance. A subset of patients with chronic rhinosinusitis with nasal polyposis (CRSwNP), however, may continue to have persistent mucosal inflammatory and aggressive polyp regrowth despite standard FESS and maximal pharmacology therapy, leading to recurrent and recalcitrant disease...
2016: Advances in Oto-rhino-laryngology
Adam S DeConde, Timothy L Smith
Endoscopic sinus surgery is an effective intervention at improving quality of life for patients with medically refractory chronic rhinosinusitis. The evidence supporting frontal sinusotomy is limited to single institution case series. However, the data for Draf IIa frontal sinusotomy do demonstrate that most patients experience lasting frontal sinus patency on postoperative endoscopic examination and improvements in quality of life. Salvage endoscopic frontal sinus surgery via a Draf III shows high rates of neo-ostium patency and subjective improvements in symptoms at a 2-year time point in case series...
August 2016: Otolaryngologic Clinics of North America
John R Craig, Dmitriy Petrov, Sammy Khalili, Steven G Brooks, John Y K Lee, Nithin D Adappa, James N Palmer
INTRODUCTION: Cerebrospinal fluid (CSF) leak occurs in 1-11% of endoscopic Draf III, or endoscopic modified Lothrop, procedures. CSF leak can occur during surgery during a superior nasal septectomy. This study investigated whether the posterior edge of the nasofrontal beak (NFB) at the level of the internal frontal ostium is a safe landmark to use to avoid skull base injury when beginning the superior septectomy. METHODS: Preoperative computed tomography maxillofacial scans were reviewed from 100 patients from the University of Pennsylvania sinus surgery data base...
May 2016: American Journal of Rhinology & Allergy
Jessica W Grayson, Sunny S Khichi, Do-Yeon Cho, Kristen O Riley, Bradford A Woodworth
OBJECTIVE: Inverted papilloma attached to the ventral skull base presents a surgical dilemma because surgical removal of the bony pedicle is critical to decrease risk of recurrence. The objective of this study is to evaluate the effectiveness of endoscopic management of skull base inverted papilloma. STUDY DESIGN: Case series with planned data collection. SETTING: Tertiary medical center. SUBJECTS: Patients with skull base inverted papilloma...
July 2016: Otolaryngology—Head and Neck Surgery
Francesca Romana Fiorini, Claudia Nogueira, Benjamin Verillaud, Anshul Sama, Philippe Herman
OBJECTIVES/HYPOTHESIS: 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. STUDY DESIGN: 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. METHODS: From an initial pool of 48 patients with frontal sinus disease to be treated with a Draf IIb, we prospectively selected 46 (95...
March 12, 2016: Laryngoscope
John R Craig, Kai Zhao, Ngoc Doan, Sammy Khalili, John Y K Lee, Nithin D Adappa, James N Palmer
BACKGROUND: Investigations into the distribution of sinus irrigations have been limited by labor-intensive methodologies that do not capture the full dynamics of irrigation flow. The purpose of this study was to validate the accuracy of a computational fluid dynamics (CFD) model for sinonasal irrigations through a cadaveric experiment. METHODS: Endoscopic sinus surgery was performed on 2 fresh cadavers to open all 8 sinuses, including a Draf III procedure for cadaver 1, and Draf IIb frontal sinusotomies for cadaver 2...
April 2016: International Forum of Allergy & Rhinology
Justin H Turner, Reza Vaezeafshar, Peter H Hwang
BACKGROUND: Extended frontal surgery techniques are often required when maximal medical therapy and standard endoscopic surgical approaches fail in patients. Although outcomes of the Draf III (modified Lothrop) procedure have been widely reported, postoperative outcomes and indications for the Draf IIB frontal sinusotomy have been relatively underreported. We presented our institution's experience with the Draf IIB procedure. METHODS: Patients who underwent the Draf IIB frontal sinusotomy between 2007 and 2012 were identified by retrospective chart review...
January 2016: American Journal of Rhinology & Allergy
Elisa A Illing, Do Yeon Cho, Kristen O Riley, Bradford A Woodworth
BACKGROUND: The Draf III procedure is an effective endoscopic approach to the treatment of frontal sinus disorders, but has a significant restenosis rate. The objective of the current study is to assess long-term success of the Draf III mucosal grafting technique. METHODS: Patients undergoing Draf III with mucosal grafting technique were prospectively enrolled. Demographics, indication for surgery, anterior-posterior (AP) diameter of frontal ostium, and complications were recorded...
May 2016: International Forum of Allergy & Rhinology
Rainer K Weber, Werner Hosemann
Endonasal endoscopic sinus surgery is the standard procedure for surgery of most paranasal sinus diseases. Appropriate frame conditions provided, the respective procedures are safe and successful. These prerequisites encompass appropriate technical equipment, anatomical oriented surgical technique, proper patient selection, and individually adapted extent of surgery. The range of endonasal sinus operations has dramatically increased during the last 20 years and reaches from partial uncinectomy to pansinus surgery with extended surgery of the frontal (Draf type III), maxillary (grade 3-4, medial maxillectomy, prelacrimal approach) and sphenoid sinus...
2015: GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery
Henry P Barham, Vijay R Ramakrishnan, Anna Knisely, Timothy Quy-Phong Do, Lyndon S Chan, Dakshika A Gunaratne, Jared D Weston, Sheran Seneviratne, George N Marcells, Raymond Sacks, Richard J Harvey
BACKGROUND: Effective mucus lavage and delivery of topical pharmaceuticals are central to successful management of chronic rhinosinusitis (CRS). The frontal sinus remains difficult to penetrate with topical therapies. This study evaluates the benefit of Draf III frontal dissection compared to traditional Draf IIa for distribution of topical therapies. METHODS: Fresh human cadaver heads were dissected sequentially with Draf IIa frontal sinusotomy and then Draf III procedures...
March 2016: International Forum of Allergy & Rhinology
Rui Peng, Qian Huang, Na Liang, Shunjiu Cui, Zhenxiao Haung, Yunchuan Li, Bing Zhou
OBJECTIVE: To evaluate the prognosis of Draf II b surgery in treating fontal sinus inverted papilloma. METHOD: A retrospective study was carried out among 15 patients diagnosed as fontal sinus inverted papilloma, which had underwent endoscopic Draf II b surgery. The clinical success rate and surgical success rate were calculated by survival analysis. RESULT: In all patients, there were 1 (6.67%) recurrence,1 (6.67%) stenosis, 4 (26.67)% complete closure, and 1 (6...
August 2015: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Apostolos Karligkiotis, Andrea Pistochini, Mario Turri-Zanoni, Paola Terranova, Luca Volpi, Paolo Battaglia, Maurizio Bignami, Paolo Castelnuovo
BACKGROUND: The management of frontal sinus disease still remains a challenging issue for rhinologists. Although endoscopic frontal sinus surgery has significantly advanced over the past years, there are some conditions in which the external approaches are still necessary. Recently, the increasing experience in endoscopic sinus surgery together with important technologic advancements have allowed expansion of the indications for selected lesions localized more and more lateral into the frontal sinus...
November 2015: American Journal of Rhinology & Allergy
Zhixian Liu, Xiaohui Li, Hailiang Zhao, Peng Wang, Yongjin Wu, Xingwei Li, Shibo Ma
OBJECTIVE: To investigate the possibility and anatomy landmark of the frontal beak approach of endoscopic frontal sinusotomy to the frontal sinus lesions. METHOD: (1)Twenty cases of frozen cadaveric head underwent spiral computed tomography scans. Then data were transferred into the Mimics image workstation to reorganize CT images in the coronal, sagittal, and axial planes. The anatomic parameters related to surgical approach points were measured, such as the distance between vertical plate of the middle turbinate and lamina papyracea and the thickness of the frontal beak...
June 2015: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Kai Zhao, John R Craig, Noam A Cohen, Nithin D Adappa, Sammy Khalili, James N Palmer
OBJECTIVES/HYPOTHESIS: Topical sinus irrigations play a critical role in the management of sinonasal disease, and the improvement in irrigant penetration into the sinuses postoperatively greatly contributes to the success of endoscopic sinus surgery. Prior investigations on postoperative sinus irrigations have been mostly limited to cadaver studies, which are labor intensive and do not capture the full dynamics of the flows. A pilot study was conducted to investigate the impact of surgery on sinus irrigation through computational fluid dynamics (CFD) simulations...
March 2016: Laryngoscope
N A van der Poel, F S Hansen, C Georgalas, W J Fokkens
No abstract text is available yet for this article.
October 2016: Clinical Otolaryngology
Anna Knisely, Henry P Barham, Richard J Harvey, Raymond Sacks
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...
September 2015: American Journal of Rhinology & Allergy
Osaama H Khan, Roheen Raithatha, Paolo Castelnuovo, Vijay K Anand, Theodore H Schwartz
BACKGROUND: The Draf III (modified endoscopic Lothrop) procedure has been proposed to extend the endonasal transethmoidal, transfovea ethmoidalis, and transcribriform approach through the back wall of the frontal sinus. The exposure is time-consuming and increases the risk of cerebrospinal fluid leak, and the indications for use are not well described. There are few data quantifying the advantage it conveys over the approach without the Draf III procedure. METHODS: An endoscopic, endonasal transfovea, transcribriform approach was performed in 5 fresh, injected cadaveric heads...
January 2016: World Neurosurgery
A Garin, B Thierry, N Leboulanger, T Blauwblomme, D Grevent, S Blanot, N Garabedian, V Couloigner
AIM: To analyze the indications and outcomes of open neurosurgical approaches (ONA) and endoscopic transnasal approaches (ETA) in the surgical management of pediatric sinogenic subdural and epidural empyema. MATERIAL AND METHODS: Retrospective single-center study design within a tertiary care referral center setting. Children less than 18 years of age consecutively operated on between January 2012 and February 2014 for drainage of a sinogenic subdural empyema (SE) or epidural (EE) empyema were included...
October 2015: International Journal of Pediatric Otorhinolaryngology
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