Endoscopic Modified Lothrop Approach (Outside-In Technique)

Abstract

The modified endoscopic Lothrop procedure, Draf III, or common frontal sinusotomy is an important surgical approach with a variety of clinical indications. The most common application for the procedure is in the management of chronic inflammatory sinus disease, but many primary pathologies of the frontal sinus can be addressed using the approach. Additionally, the Draf III is an important surgical adjunct to anterior ventral skull base resections and reconstruction. Modifications to the technique include the outside-in approach, and newer instrumentation increases surgical efficiency in creating a functional common cavity that provides improved topical and surgical access to the frontal sinus.