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Long-term stenting for chronic frontal sinus disease: case series and literature review

Published online by Cambridge University Press:  20 May 2010

B Hunter ,
S Silva ,
R Youngs ,
A Saeed  and
V Varadarajan
B Hunter*
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Gloucestershire Royal Hospital, Gloucester, UK
S Silva
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Gloucestershire Royal Hospital, Gloucester, UK
R Youngs
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Gloucestershire Royal Hospital, Gloucester, UK
A Saeed
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Gloucestershire Royal Hospital, Gloucester, UK
V Varadarajan
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Gloucestershire Royal Hospital, Gloucester, UK
*
Address for correspondence: Mr B Hunter, Department of Otolaryngology/Head and Neck Surgery, Gloucestershire Royal Hospital, Great Western Road, Gloucester GL1 3NN, UK. E-mail: benhunter@doctors.org.uk
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Abstract

Objective:

The frontal sinus outflow tract consists anatomically of narrow channels prone to stenosis. Following both endonasal and external approach surgery, up to 30 per cent of patients suffer post-operative re-stenosis of the frontal sinus outflow tract, with recurrent frontal sinus disease. This paper proposes the surgical placement of a long-term frontal sinus stent to maintain fronto-nasal patency, as an alternative to more aggressive surgical procedures such as frontal sinus obliteration and modified Lothrop procedures.

Design:

We present a series of three patients with frontal sinus disease and significant co-morbidity, the latter making extensive surgery a significant health risk. We also review the relevant literature and discuss the use of long-term frontal sinus stenting.

Results:

These three cases were successfully treated with long-term frontal sinus stenting. Stents remained in situ for a period ranging from 48 to over 60 months.

Conclusion:

Due to the relatively high failure rates for both endonasal and external frontal sinus surgery, with a high post-operative incidence of frontal sinus outflow tract re-stenosis, long-term stenting is a useful option in carefully selected patients.

Keywords

Frontal SinusStentsPathologic ConstrictionEndoscopy

Information

Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 11 , November 2010 , pp. 1216 - 1222
Copyright
Copyright © JLO (1984) Limited 2010

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References

1 Hoyt, WH 3rd. Endoscopic stenting of nasofrontal communication in frontal sinus disease. Ear Nose Throat J 1993;72:596–7CrossRefGoogle ScholarPubMed
2 Shikani, AH. A new middle meatal antrostomy stent for functional endoscopic sinus surgery. Laryngoscope 1994;104:638–41CrossRefGoogle ScholarPubMed
3 Rains, BM 3rd. Frontal sinus stenting. Otolaryngol Clin North Am 2001;34:101–10CrossRefGoogle ScholarPubMed
4 Benoit, CM, Duncavage, JA. Combined external and endoscopic frontal sinusotomy with stent placement: a retrospective review. Laryngoscope 2001;111:1246–9CrossRefGoogle ScholarPubMed
5 Neel, HB, Whicker, JH, Lake, CF. Thin rubber sheeting in frontal sinus surgery: animal and clinical studies. Laryngoscope 1976;86:524–36CrossRefGoogle ScholarPubMed
6 Weber, R, Hosemann, W, Draf, W, Keerl, R, Schick, B, Schinzel, S. Endonasal frontal sinus surgery with permanent implantation of a place holder. Laryngorhinootologie 1997;76:728–34CrossRefGoogle ScholarPubMed
7 Lynch, RC. The technique of a radical frontal sinus operation which has given me the best results. Laryngoscope 1921;21:1–5CrossRefGoogle Scholar
8 Barton, RT. Dacron prosthesis in frontal sinus surgery. Laryngoscope 1972;82:1799–805CrossRefGoogle ScholarPubMed
9 Yamasoba, T, Kikuchi, S, Higo, R. Transient positioning of a silicone T tube in frontal sinus surgery. Otolaryngol Head Neck Surg 1994;111:776–80CrossRefGoogle ScholarPubMed
10 Amble, FR, Kern, EB, Neel, HB. Nasofrontal duct reconstruction with silicone rubber sheeting for inflammatory frontal sinus disease: analysis of 164 cases. Laryngoscope 1996;106:809–15CrossRefGoogle ScholarPubMed
11 Schaefer, SD, Close, LG. Endoscopic management of frontal sinus disease. Laryngoscope 1990;100:155–60CrossRefGoogle ScholarPubMed
12 Weber, R, Mai, R, Hosemann, W, Draf, W, Toffel, P. The success of 6-month stenting in endonasal frontal sinus surgery. Ear Nose Throat J 2000;79:930–2, 934, 937, 938, 940, 941CrossRefGoogle ScholarPubMed
13 Freeman, SB, Blom, ED. Frontal sinus stents. Laryngoscope. 2000;110:1179–82 (Erratum in: Laryngoscope 2000;110:1976)CrossRefGoogle ScholarPubMed
14 Gross, WE, Gross, CW, Becker, D, Moore, D, Phillips, D. Modified transnasal endoscopic Lothrop procedure as an alternative to frontal sinus obliteration. Otolaryngol Head Neck Surg 1995;113:427–34CrossRefGoogle ScholarPubMed
15 Draf, W. Endonasal micro-endoscopic frontal sinus surgery: the Fulda concept. Oper Techn Otolaryn Head Neck Surg 1991;2:234–40CrossRefGoogle Scholar
16 Seth J, Kanowitz, Joseph B, Jacobs, Richard, A Lebowitz. Frontal sinus stenting. In: Kountakis, S, Senior, B, Draf, W. The Frontal Sinus. Berlin Germany: Springer, 2005:261–266Google Scholar
17 Hosemann, W, Kuhnel, TH, Held, P, Wagner, W, Felderhoff, A. Endonasal frontal sinusotomy in surgical management of chronic sinusitis: a critical evaluation. Am J Rhinol 1997;11:1–19CrossRefGoogle ScholarPubMed
18 Casiano, RR, Livingston, JA. Endoscopic Lothrop procedure: the University of Miami experience. Am J Rhinol 1998;12:335–9CrossRefGoogle ScholarPubMed
19 Hosemann, W, Wigand, ME, Gode, U, Langer, F, Dunker, I. Normal wound healing of the paranasal sinuses – clinical and experimental investigations. Eur Arch Otorhinolaryngol 1991;248:390–4CrossRefGoogle ScholarPubMed
20 Beule, AG, Sharf, C, Biebler, KE, Gopferich, A, Steinmeier, E, Wolf, E et al. Effects of topically applied dexamethasone on mucosal wound healing using a drug-releasing stent. Laryngoscope 2008;118:2073–7CrossRefGoogle ScholarPubMed
21 Lin, D, Witterick, IJ. Frontal sinus stents: how long can they be kept in? J Otolaryngol Head Neck Surg 2008;37:119–23Google Scholar
22 Baron, SH, Dedo, HH, Henry, CR. The mucoperiosteal flap in frontal sinus surgery (the Sewall-Boyden-McNaught operation). Laryngoscope 1973;80:1266–80CrossRefGoogle Scholar
23 Orlandi, RR, Knight, J. Prolonged stenting of the frontal sinus. Laryngoscope 2009;119:190–2CrossRefGoogle ScholarPubMed
24 Perloff, JR, Palmer, JN. Evidence of bacterial biofilms on frontal recess stents in patients with chronic rhinosinusitis. Am J Rhinol 2004;18:377–80CrossRefGoogle ScholarPubMed
25 Chadwell, JS, Gustafson, LM, Tami, TA. Toxic shock syndrome associated with frontal sinus stents. Otolaryngol Head Neck Surg 2001;124:573–4CrossRefGoogle ScholarPubMed