Clinical application of Draf Ⅱ b frontal sinusotomy and it's modified procedures
10.3760/cma.j.issn.1673-0860.2012.05.003
- VernacularTitle:Draf Ⅱ b额窦手术及其变通术式的临床应用
- Author:
Bing ZHOU
1
;
Cheng-Shuo WANG
;
Qian HUANG
;
Shun-Jiu CUI
;
Yun-Chuan LI
;
Gui-Sheng WANG
;
Li-Li ZHANG
;
Zhen-Xiao HUANG
;
Yan SUN
Author Information
1. 首都医科大学附属北京同仁医院
- Keywords:
Endoscopy;
Otorhinolaryngologic surgical procedures;
Frontal sinus;
Choice behavior
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2012;47(5):358-362
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the follow-up outcomes of Draf Ⅱ b frontal sinusotomy and it's modified procedures,and to discuss the surgical indications and prognostic factors.Methods Thirty-two patients treated between 2004 and 2010 were enrolled in this study.There were 15 patients for recurrent frontal inverted papilloma ( IP),6 for mucocele,4 for recurrent frontal sinusitis,3 for osteoma,2 for meningoeneephalocele with cerebrospinal fluid rhinorrhea,1 for meningoencephalocele alone and 1 for acute frontal sinusitis.All patients underwent preoperative paranasal sinus computed tomography (CT) scans.Patients with tumor accepted magnetic resonance imaging (MRI).The patients with meningoencephalocele and cerebrospinal fluid rhinorrhea recieved magnetic resonance cistemography (MRC).The Draf Ⅱ b frontal sinusotomy and it's modified Draf Ⅱ b-1 -3 procedures were applied endoscopically under general anesthesia mainly by high speed bur and power system.The postoperative CT scan was obtained as a base line for follow-up 1 week after the operation.Postoperative follow-up was performed under endoscope.Results Among 19 cases of Draf Ⅱ b,12 were recurrent IP of frontal sinus,4 were mucocele,2 were recurrent frontal sinusitis and 1 were osteoma.Five cases received Draf Ⅱ b-1,2 for each recurrent IP of frontal sinus and recurrent frontal sinusitis and 1 for osteoma. Six cases received Draf Ⅱ b-2, 3 for meningoencephalocele,1 for each IP,acute frontal sinusitis and osteoma.Two cases received Draf Ⅱ b-3 were mucocele.The follow-up ranged from 8 to 73 months.Twenty-two cases of the frontal neoostium were widely opened,7 were stenosis and 3 were closed.Revision surgery was seen in 2 cases with IP.All of them had no complications.Conclusions The Draf Ⅱ b frontal sinusotomy and it's modified procedures are suitable for complex frontal sinus disease,which can be selected according to pathological and anatomical features,and have a good prospect for clinical application.
