Endoscopic frontal sinus drillout in 100 patients.

OBJECTIVE

To determine the efficacy of frontal sinus drillout surgery for the treatment of chronic frontal sinusitis.

DESIGN

Retrospective case-control study. Mean +/- SD follow-up was 4.1 +/- 1.53 years (range, 1.4-6.9 years).

SETTING

Academic medical center.

PATIENTS: One hundred consecutive patients with chronic sinusitis who underwent frontal sinus drillout surgery. Indications were failed previous frontal sinusotomy (n = 88) and frontal sinus mucocele (n = 12).

INTERVENTIONS: Endoscopic removal of the floor of the frontal sinus (unilateral, n = 34; bilateral, n = 66) with a surgical drill. An intraoperative image-guidance system was used in 65 patients.

MAIN OUTCOME MEASURES: Frontal sinus patency and improvement of symptoms associated with frontal sinusitis.

RESULTS

Frontal sinus patency with control of symptoms was achieved in 80% of patients. There were no intraoperative complications. Postoperative epistaxis occurred in 4% of patients. Of the 20 patients who developed restenosis of the frontal sinus ostium, 11 underwent revision frontal sinus drillout and 9 proceeded to frontal sinus obliteration. The success rate was comparable for the image-guidance and non-image-guidance groups (83.1% vs 74.3%, respectively; P =.56).

CONCLUSIONS

Frontal sinus drillout performed with or without an image-guidance system appears to be a safe and effective surgery for the treatment of patients with advanced disease of the frontal sinus. This procedure provides a reasonable alternative to frontal sinus obliteration, which remains a treatment option for patients who fail frontal drillout.