Treatment of recurrent barotraumatic and infectious frontal sinusitis by navigated balloon dilation of the nasofrontal duct.

INTRODUCTION

Recurrent barotraumatic or isolated infectious frontal sinusitis is linked to anatomical variants of the nasofrontal duct (NFD). Anterior ethmoidectomy, the standard treatment, is incomplete in 50-80% of cases, incurring a 19% rate of stenosis. Balloon dilation of the NFD could be an alternative.

OBJECTIVES

The primary study objective was to evaluate the safety of the device. The secondary objective was to analyze its long-term efficacy.

MATERIALS AND

METHODS

This was a retrospective single-center study including patients treated by NFD enlargement using a navigated dilation balloon. The following data were collected: pre- and post-operative symptoms, preoperative CT scans, follow-up time, return to activities, adverse effects and complications, additional care, and patient satisfaction.

RESULTS

Twenty-one patients were included: 10 with recurrent isolated infectious sinusitis and 11 with recurrent barotraumatic sinusitis (27 frontal sinuses). There was 1 case of eyelid ecchymosis, and no CSF leaks. Mean follow-up was 36.3±38 months. Ninety-one percent of patients were able to resume their activities involving pressure variations. None required hospitalization, repeat consultation or surgical revision. Four patients experienced symptom recurrence, including 2 for reasons other than the frontal sinus. 86% of patients were satisfied with the procedure, 9.5% were indifferent, and only 1 patient was dissatisfied (recurrence of headaches).

CONCLUSION

Navigated balloon dilation of the NFD was a safe and effective treatment option for these two indications and could replace ethmoidectomy as a first-line procedure.