Endoscopic minitrephination combined with endoscopic frontal sinusotomy for management of chronic frontal sinusitis

Objective:To evaluate the efficacy of endoscopic minitrephination combined with endoscopic frontal sinusotomy in the management of complex chronic frontal sinusitis.Method:Twenty-six patients suffering from chronic frontal sinusitis with complex frontal drainage approach were analyzed.Eleven patients(13sides)received endoscopic minitrephination combined with endoscopic frontal sinusotomy,while the other 15patients(18sides) received endoscopic frontal sinusotomy only.Postoperatively all cases were followed up to evaluate the efficacy. Result:The ostia of frontal sinus were successfully opened in the group of patients received endoscopic minitrephination combined with endoscopic frontal sinusotomy without any complications.In the endoscopic frontal sinusotomy only group,three cases of complications were observed,one with the injury of anterior ethmoidal artery and the other two with the injury of papyraceous lamina.After 10to 24 months of follow up postoperatively,the symptoms were relieved in all cases without recurrence.The combined surgery group with endoscopic minitrephination showed an endoscopic frontal sinus patency rate of 85%,and the endoscopic frontal sinusotomy only group exhibited an endoscopic frontal sinus patency rate of 83%.Conclusion:Endoscopic minitrephination combined with endoscopic frontal sinusotomy is a simple,convenient,safe and effective method for management of complex chronic frontal sinusitis.