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Where endoscopy fails: indications and experience with the frontal sinus fat obliteration


Soyka, M B; Annen, A; Holzmann, D (2009). Where endoscopy fails: indications and experience with the frontal sinus fat obliteration. Rhinology, 47(2):136-140.

Abstract

BACKGROUND: With the event of angled endoscopes, image guidance and the rapidly improving endoscopic techniques the previously used osteoplastic frontal sinus fat obliteration (ISO) becomes more and more a second line treatment option. The objective of our study is to describe the up-to-date indications for FSO based on our own experience. METHODS: Retrospective analysis including follow-up visits of 77 patients with frontal sinus fat obliteration at our clinic between 1991 and 2006 was undertaken and descriptive statistics were drawn. RESULTS: Thirty-six cases were operated by FSO as a first-line treatment, 41 had previous surgery. Eighty percent of all patients showed no postoperative residual complaints. Two patients required revision surgery. General complication rate was 36.4%, however these consisted in the vast majority of cases (90%) of minor complications. CONCLUSIONS: FSO still remains a valuable operation for specific indications. FSO is the gold standard for repeatedly failed endoscopic procedures. The operation should also target the following indications as a first-line treatment: large/lateral osteomas, malignant disease, lateral mucoeceles, most fractures of the posterior sinus wall with CSF-leak, osteomyelitis, pathologies in small underdeveloped sinuses with narrow floor. It is associated with minimal complications and a good outcome.

BACKGROUND: With the event of angled endoscopes, image guidance and the rapidly improving endoscopic techniques the previously used osteoplastic frontal sinus fat obliteration (ISO) becomes more and more a second line treatment option. The objective of our study is to describe the up-to-date indications for FSO based on our own experience. METHODS: Retrospective analysis including follow-up visits of 77 patients with frontal sinus fat obliteration at our clinic between 1991 and 2006 was undertaken and descriptive statistics were drawn. RESULTS: Thirty-six cases were operated by FSO as a first-line treatment, 41 had previous surgery. Eighty percent of all patients showed no postoperative residual complaints. Two patients required revision surgery. General complication rate was 36.4%, however these consisted in the vast majority of cases (90%) of minor complications. CONCLUSIONS: FSO still remains a valuable operation for specific indications. FSO is the gold standard for repeatedly failed endoscopic procedures. The operation should also target the following indications as a first-line treatment: large/lateral osteomas, malignant disease, lateral mucoeceles, most fractures of the posterior sinus wall with CSF-leak, osteomyelitis, pathologies in small underdeveloped sinuses with narrow floor. It is associated with minimal complications and a good outcome.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Otorhinolaryngology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2009
Deposited On:21 Jul 2009 15:17
Last Modified:05 Apr 2016 13:18
Publisher:International Rhinologic Society
ISSN:0300-0729
PubMed ID:19593968
Permanent URL: http://doi.org/10.5167/uzh-19767

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