Outside-in frontal drill-out: How I do It with illustration and video

Anna Knisely*, Henry P. Barham, Richard J. Harvey, Raymond Sacks

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    23 Citations (Scopus)


    Background: The Draf 3 frontal sinusotomy, or modified Lothrop procedure has been used to treat recalcitrant rhinosinusitis, frontal sinus mucocoeles or to provide access for cerebrospinal fluid leaks, frontoethmoid fractures, frontal sinus tumors and skull base tumors. Objective: To describe authors approach to the "Outside-In Frontal Drill-Out". Methods: Descriptive. Results: The "Outside-In" frontal drill-out is an approach that emphasizes the early identification of the first olfactory neuron, maximization of bone removal, and preservation of the posterior table mucosa. Conclusion: The advantages of this approach are it provides unobstructed view and identifies anatomic limits early, bone removal is fast and efficient; it is safe, and it is a robust technique based upon fixed anatomic landmarks.

    Original languageEnglish
    Pages (from-to)397-400
    Number of pages4
    JournalAmerican Journal of Rhinology and Allergy
    Issue number5
    Publication statusPublished - 12 Sept 2015


    Dive into the research topics of 'Outside-in frontal drill-out: How I do It with illustration and video'. Together they form a unique fingerprint.

    Cite this