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Abstract

Isolated Frontal Sinus Surgery Pathologies


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Authors
Özer Erdem Gur, Didem Nevreste Sonbay Yılmaz, Nuray Ensari

J Clin Anal Med 2017;8(3):235-238
doi:10.4328/JCAM.4809

Abstract
Aim: Frontal sinus pathologies are seen less often than other paranasal sinus pathologies. However, the close proximity of the frontal sinus to important anatomic structures can cause significant symptoms and complications. The pathologies most frequently seen in the frontal sinus are mucoceles and osteoma. In this study, a retrospective scan was made of patients operated on for frontal sinus pathology and these patients were evaluated in light of the literature. Material and Method: A retrospective evaluation was made of 1143 patients who underwent endoscopic sinus surgery between September 1999 and March 2016. The patients included in the study were those operated on for a diagnosis of frontal osteoma in 12 cases and for frontal mucocele in 44 cases. Result: Of the total 1143 patients initially scanned, isolated frontal sinus pathology was determined in only 56 (4.8%). These patients underwent surgery for frontal osteoma in 12 cases and for frontal mucocele in 44 cases. In 12 patients diagnosed with osteoma, surgery was performed with the external approach. Bicoronal flap was applied in 2 patients and inside eyebrow incision in 10. Of the 44 patients diagnosed with mucocele, surgery was performed with the external approach on 13 patients. In 3 patients with frontal sinus anterior wall defect and frontal recess obliterated on PNS CT, the endoscopic approach was combined with osteoplastic flap. After repair of the dura defect with graft taken from the fascia lata, the frontal sinus ws obliterated with fat tissue taken from the abdomen. Of the 44 patients diagnosed with mucocele, surgery was performed with the endoscopic approach on 28 patients. Discussion: The surgical approaches in frontal sinus pathologies remain a matter of debate. Although endoscopic sinus surgery has been the gold standard among all paranasal surgical approaches since it was first introduced, external approaches still remain current. The general view is that if there is a defect in the frontal sinus anterior wall and there is extension outside the sinus to the orbit wall in particular, if the lesion has lateral localisation within the frontal sinus, or if there is a defect in the posterior dura, external surgery should be preferred to external surgery.

Keywords : Frontal sinüs, surgery, mucocel, osteoma,

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How to Cite :
Özer Erdem Gur, Didem Nevreste Sonbay Yılmaz, Nuray Ensari, Isolated Frontal Sinus Surgery Pathologies, J Clin Anal Med 2017;8.(3):235-238