LONG-TERM RESULTS AFTER ENDONASAL FRONTAL -SINUS SURGERY

Most conditions of the frontal sinus requiring surgery can now be mana ged successfully by endonasal procedures. To date there has been no cl ear position regarding indications and results of different types of e ndonasal frontal sinus drainage. In a retrospective study we evaluated long-term results of Draf's type II and III endonasal frontal sinus d rainages using endoscopy and computed tomography. Twelve to 98 months following type II drainage, 58% of 83 frontal sinuses were ventilated and normal. A ventilated frontal sinus but with hyperplastic mucosa wa s seen in 12%. Scarred occlusion with total opacification on CT occurr ed in 14%. Furthermore, total opacification in 16% was due to recurren t polyposis. Patients were free of symptoms or had only minor problems in 79%. Twelve to 89 months following type III drainage, 59% of 81 fr ontal sinuses were ventilated and normal. A ventilated frontal sinus w ith hyperplastic mucosa was seen in 17%. Scarred occlusion with total opacification on CT was present in 7%. Furthermore, total opacificatio n in 16% was due to recurrent polyposis. In all, 95% of the patients w ere free of symptoms or had only minor problems. Combining our results with those of other authors and utilizing the physiology of wound hea ling after sinus surgery, we developed a protocol of differential indi cations for endonasal frontal sinus drainage.