MODIFIED TRANSNASAL ENDOSCOPIC LOTHROP PROCEDURE - FURTHER CONSIDERATIONS

The Lothrop procedure resects the medial frontal sinus floor, superior nasal septum, and intersinus septum to create a large frontonasal com munication. However, the external approach often allowed medial collap se of soft tissue and stenosis of the nasofrontal communication. We de scribe a modified transnasal endoscopic Lothrop procedure in which dri lls are used for cases in which frontal recess exploration fails to re lieve obstruction of the frontal sinus. The lateral bony walls are pre served, and medial collapse does not occur. The mucosa of the posterio r table and posterior nasofrontal duct is preserved, and a single comm on frontal opening is created. We have found this approach to be safe and reliable. Fourteen patients have undergone this procedure without complication, achieving resolution or improvement of their symptoms an d maintaining wide patency of the frontonasal opening. We recognize th at long-term follow-up mill be required but remain encouraged with our favorable results to date.