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Feasibility of a septal mucosal flap for preventing re-stenosis following the Draf III procedure

  • O Erdur (a1), K Ozturk (a1) and K Erkan (a1)
Abstract
Background:

Re-stenosis and a consequent need for revision surgery are the most common problems in the follow-up period following endoscopic modification of the Lothrop procedure.

Method:

This paper reports a new technique for reconstructing and resurfacing of the posterior frontal recess bone for prevention of re-stenosis.

Results:

A 46-year-old man presented with a frontal sinus osteoma, and treatment featured an endoscopic modification of the Lothrop procedure. A vascularised, posteriorly based, septal mucosal flap was used in reconstruction. There have been no reported issues over 24 months of follow up.

Conclusion:

The use of a nasoseptal flap seems feasible to reduce scarring and recurrence of (common) frontal recess stenosis after a Draf III operation.

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Copyright
Corresponding author
Address for correspondence: Dr Omer Erdur, Department of Otolaryngology, Selcuk University Medical School, Alaeddin Keykubad Campus, 42075 Yeni Istanbul Caddesi, Konya, Turkey E-mail: dromerdur@yahoo.com
References
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1 Draf, W. Endonasal micro-endoscopic frontal sinus surgery: the Fulda concept. Oper Tech Otolaryngol Head Neck Surg 1991;2:234–40
2 Chin, D, Snidvongs, K, Kalish, L, Sacks, R, Harvey, RJ. The outside-in approach to the modified endoscopic Lothrop procedure. Laryngoscope 2012;122:1661–9
3 Wormald, PJ. Salvage frontal sinus surgery: the endoscopic modified Lothrop procedure. Laryngoscope 2003;113:276–83
4 Rajapaksa, SP, Ananda, A, Cain, TM, Oates, L, Wormald, PJ. Frontal ostium neo-osteogenesis and restenosis after modified endoscopic Lothrop procedure in an animal model. Clin Otolaryngol Allied Sci 2004;29:386–8
5 Hadad, G, Bassagasteguy, L, Carrau, RL, Mataza, JC, Kassam, A, Snyderman, CH et al. A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. Laryngoscope 2006;116:1882–6
6 Shirazi, MA, Silver, AL, Stankiewicz, JA. Surgical outcomes following the endoscopic modified Lothrop procedure. Laryngoscope 2007;17:765–9
7 Anderson, P, Sindwani, R. Safety and efficacy of the endoscopic modified Lothrop procedure: a systematic review and meta-analysis. Laryngoscope 2009;119:1828–33
8 Seyedhadi, S, Mojtaba, MA, Shahin, B, Hoseinali, K. The Draf III septal flap technique: a preliminary report. Am J Otolaryngol 2013;34:399402
9 Jones, V, Virgin, F, Riley, K, Woodworth, BA. Changing paradigms in frontal sinus cerebrospinal fluid leak repair. Int Forum Allergy Rhinol 2012;2:227–32
10 AlQahtani, A, Bignami, M, Terranova, P, Digilio, E, Basilico, F, Abdulrahman, S et al. Newly designed double-vascularized nasoseptal flap to prevent restenosis after endoscopic modified Lothrop procedure (Draf III): laboratory investigation. Eur Arch Otorhinolaryngol 2014;271:2951–5
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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