The role of frontal sinus drillouts in nasal polyposis

Carolyn A. Orgain, Richard J. Harvey*

*Corresponding author for this work

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

Purpose of review: Historically, the common frontal sinusotomy has been reserved only for salvage frontal sinus surgery in patients with severely recalcitrant inflammatory sinus disease. By understanding the pathophysiology of inflammatory sinus disease and the long-term role of topical medication in their treatment, the indications for Draf3 have expanded. 

Recent findings: A major therapeutic impact from endoscopic sinus surgery for inflammatory sinus disease is imparted by allowing sinus access to topical therapies to work. Although traditionally, the Draf3 frontal sinus procedure has been reserved for revision surgery in severe cases, advancements in technology, instrumentation, and techniques has allowed the Draf3 to evolve to efficient and safe procedure, often applied primarily in select patients. There is evidence to support the indication for Draf3 in primary surgery for severe cases. 

Summary: In inflammatory sinus disease, the goal of endoscopic sinus surgery is to convert the complex and limited frontal sinus outflow tracts into a simple common cavity. This allows for local, topical anti-inflammatory treatments to control the disease. When patients have broader inflammatory airway disease and asthma, the Draf3, as part of a neo-sinus cavity, is commonly applied early in surgical care.

Original languageEnglish
Pages (from-to)34-40
Number of pages7
JournalCurrent Opinion in Otolaryngology and Head and Neck Surgery
Volume26
Issue number1
DOIs
Publication statusPublished - 1 Feb 2018

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Keywords

  • chronic rhinosinusitis with polyposis
  • common frontal sinusotomy
  • Draf III
  • esosinophilic chronic rhinosinusitis
  • frontal drill-out
  • frontal sinus
  • lothrop
  • modified endoscopic lothrop
  • outside-in

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