OPERATIVE TREATMENT OF FRONTAL SINUSITIS

When the medical therapy fails trephination is the primary operation i ndicated in acute eroding sinusitis when drainage is necessary to avoi d severe complications. In recent years also endoscopic transnasal sur gery has been recommended for exenteration of the underlying disease i n the ostiomeatal unit as well as for opening of the obstructed nasofr ontal duct in acute phase of the disease. In Turku University Central Hospital endoscopic frontal sinus surgery is still reserved for cases with prolonged or delayed disease performed as a secondary operation a fter trephination and CT examination. Failures are common after these operations and both types of surgical treatment may be needed. Three p ercent of our patients developed a persistent chronic infection inside the frontal sinus. In these cases external osteoplastic approach is r ecommended. In these operations we have used bioactive glass as oblite ration material with promising clinical results.