Frontal sinus stenting

Abstract

The concept of frontal sinus stenting to minimize postoperative stenosis and improve mucosalization of the frontal sinus outflow tract (FSOT) following frontal sinus surgery has been reported in the literature for nearly 100 years. The external fronto-ethmoidectomy, as originally described by Lynch, involved postoperative stenting of the nasofrontal communication. Technological advances in sinus endoscopes, surgical instruments, high-resolution computed tomographic (CT) scanning, and image guidance have allowed for improved visualization and intranasal surgical access to the nasofrontal region. However, despite these advances, postoperative stenosis of the FSOT with recurrent frontal sinus disease remains a significant problem (Fig. 28.1). Factors such as polyposis, osteitic bone, and lateralization of the middle turbinate/middle turbinate remnant may lead to FSOT stenosis, regardless of the surgical approach and the adequacy of the frontal sinusotomy. Failure rates of nearly 30% have been reported in the literature - and because of this propensity for postoperative stenosis of the FSOT, stenting remains an important component in the surgical management of chronic frontal sinusitis. © Springer-Verlag Berlin Heidelberg 2005.