Volume 135, Issue 6 p. 917-921
Original Research

Limits of endoscopic visualization and instrumentation in the frontal sinus

Samuel S. Becker MD

Samuel S. Becker MD

Department of Otolaryngology–Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia

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Steven R. Bomeli BS

Steven R. Bomeli BS

Department of Otolaryngology–Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia

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Charles W. Gross MD

Charles W. Gross MD

Department of Otolaryngology–Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia

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Joseph K. Han MD

Corresponding Author

Joseph K. Han MD

Department of Otolaryngology–Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia

Reprint requests: Joseph K. Han, MD, University of Virginia Health System, Department of Otolaryngology–Head and Neck Surgery, Division of Rhinology and Sinus Surgery, PO Box 800713, Charlottesville, VA 22908–0713. E-mail address: [email protected].Search for more papers by this author
First published: 17 May 2016
Citations: 1

Dr Han is on the Speaker's Bureau for Sanofi-Aventis and Pfizer and is the recipient of a research grant from General Electric.

Support for this study has been provided by a grant from General Electric.

Presented at Annual Meeting of the American Academy of Otolaryngology–Head and Neck Surgery in Los Angeles, September 2005.

Abstract

BACKGROUND

Endoscopic limitations in the frontal sinus are poorly defined. We set out to define these limits.

METHODS

Fifteen cadaveric heads underwent endoscopic frontal sinusotomies (Draf IIA, IIB, III). Areas of frontal sinus openings were calculated. Coordinates of the most distant points for instrumentation, visualization, and instrumentation with visualization in the frontal sinus were identified with the use of image guidance.

RESULTS

Twenty-eight frontal sinuses were evaluated. The mean sinus opening areas were 47.5 mm2, 105.1 mm2, and 246.4 mm2 for Draf IIA, IIB, and III. Visualization exceeds instrumentation and visualized reach (P < 0.05) regardless of different frontal sinusotomies. Anterior and lateral instrumentation and visualized reach increase as the frontal sinus opening increases (P < 0.05). For lateral visualization, Draf III > IIB > IIA (P < 0.04). There is no statistical difference for superior visualization, instrumentation, and visualized reach among various sinusotomies (P > 0.05).

CONCLUSIONS

Endoscopic visualization exceeds instrumentation and instrumentation exceeds visualized reach. Enlarging frontal sinus opening area increases instrumentation and visualization.