Clinical Study of Surgical Treatment for Frontal Sinus Disease: Osteoplastic Frontal Sinus Surgery versus Endoscopic Sinus Surgery

Jang, Chul Ho; Kim, Jin Ok; Choi, Tae Wook

Abstract

BACKGROUND AND OBJECTIVES
Depending on the pathologic process the treatment of frontal sinus disease has consisted of obliteration of the sinus, or restoration of drainage into the nose. Endoscopic sinus surgery (ESS) gives advantages for dramatically reducing operative morbidity of surgery for frontal sinus disease by offering a minimally invasive alternative to previous osteoplastic or other radical frontal sinus surgery. We present our experience with 18 frontal sinus diseases in which osteoplastic approach or endoscopic sinus were attempted.
MATERIALS AND METHODS
Retrospective review of 18 cases were done. Ten patients were treated by ESS, and 8 cases by osteoplastic frontal sinus surgery (OFSS) with obliteration.
RESULTS
During the follow-up period, 10 patients treated by ESS had complete resolution of all symptoms but 3 cases treated by OFSS had at least one episode of headache. No recurrence of ESS patients has been noted to date according to the endoscopic follow-up of up to 16 months, and gradual absorbtion of obliterated fat without recurrence was observed. But there was no absorption of obliterated hydroxyapatite granule after long-term period. The frontal sinus can be visualized with follow-up endoscopy, and the difficult evaluation of the obliterated cavity can be avoided.
CONCLUSION
ESS is much better than OFSS, but osteoma, fracture and some limited situations are bound to be treated by OFSS. In case of OFSS, hydroxyapatite obliteration shows long-term stability than fat.