[Transnasal endoscopic frontal surgery for chronic frontal sinusitis].

ABSTRACT

OBJECTIVE: The recurrence of chronic frontal sinusitis after endoscopic surgery is mainly due to the mismanagement of frontal recess and frontal sinus orifice. The aim of this study is to investigate the characteristics of chronic frontal sinusitis and to advance the clinical therapeutic efficacy. METHODS: Different methods were used to manage different local diseases in frontal sinus orifice or frontal recess in 58 cases (96 sides) with chronic frontal sinusitis by nasal endoscopic surgery. RESULTS: Different degree of middle meatal obstruction was seen in all cases at operation. The situation of frontal sinus ostium and frontal recess was as follows 38 sides obstructed by swollen mucosa, polypoid mucosa or polyps, no cell obstruction at frontal sinus orifice; 34 cases constricted by over development of agger nasi cells, ethmoid bulla or terminal cell at frontal recess; 15 cases obstructed completely by over development cells at frontal recess; osteal stenosis at frontal sinus orifice in 9 cases. The situation in frontal sinus was as follows pus accumulation in 18 sides, mucosal swollen in 21 sides, mucosal congestion in 49 sides, no obvious mucosal diseases in 8 cases. Follow-up for 6-20 months showed that 69 sides (71.9%) were cured, 17 sides (17.7%) better and 10 cases (10.4%) recurrent. CONCLUSION: Obstruction of osteomeatal complex and frontal recess is the main causes of chronic sinusitis. There are four pathologic states in obstruction of frontal recess and frontal ostium. Different operative methods should be taken according to different pathological changes. The operative effects is still needed to improve.