Endoscopic Lothrop procedure: when should it be considered?

PURPOSE OF REVIEW: The endoscopic Lothrop procedure has proved to be an effective intranasal approach to the treatment of frontal sinus disorders. When successful, the operation re-establishes normal or near-normal frontal sinus function (especially physiologic evacuation of frontal sinus contents). Recently, several authors have proposed the use of this procedure for the treatment of several disease processes in addition to chronic frontal sinusitis.

RECENT FINDINGS: Although follow-up has been limited, the endoscopic Lothrop procedure has proved effective in the treatment of patients with the following: (1) failed prior endoscopic surgery, (2) frontal sinus mucocele, (3) frontoethmoid fractures, (4) failed osteoplastic flap frontal sinus obliteration, (5) resection of sinonasal neoplasms, and (6) removal of osteitic foci.

SUMMARY: When used by an experienced endoscopic surgeon in selected clinical settings, the endoscopic Lothrop procedure offer acceptable to excellent results with relatively low morbidity and with several advantages over more standard surgical approaches for the treatment of specific disease entities.