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Endoscopic frontotomy (anesthesia and hospitalization costs not included)

Endoscopic frontotomy (anesthesia and hospitalization costs not included)

10000.00 MDL

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Endoscopic Frontal Sinusotomy is a minimally invasive surgical procedure performed using nasal endoscopy, aimed at opening and draining the frontal sinus. The procedure is carried out through the nasal cavity without external incisions, using specialized optical and surgical instruments to treat inflammatory, infectious, or tumoral conditions of the frontal sinuses.

Components and Details

The procedure is performed via an endonasal approach using a rigid endoscope and specialized instruments.
It involves enlarging the natural opening (ostium) of the frontal sinus to allow for proper ventilation and drainage.
Techniques such as Draf I, IIa, IIb, or III (Draf III being the extended median frontal sinusotomy) are used depending on the severity of the disease and the patient’s anatomy.

Purpose and Goals of the Procedure

The aim of endoscopic frontal sinusotomy is to:

Restore physiological ventilation and drainage of the frontal sinus;
Treat chronic frontal sinusitis refractory to conservative therapy;
Excise or biopsy benign or malignant tumors in the frontal region;
Prevent orbital or intracranial complications in severe sinusitis cases.

Indications

Recurrent or refractory chronic frontal sinusitis;
Presence of nasal polyps obstructing the frontal sinus;
Frontal sinus mucoceles;
Benign tumors (osteoma, inverted papilloma) or malignant tumors (carcinoma, adenocarcinoma);
Complications from frontal trauma or previous surgeries.

Patient Preparation

Comprehensive ENT examination, including nasal endoscopy and CT scan of the sinuses;
Discontinuation of anticoagulant medication 5–7 days prior to the procedure under medical supervision;
Detailed information provided about the risks, benefits, and alternative treatment options.

Procedure

Usually performed under general anesthesia;
The surgeon inserts an endoscope through the nostril and, using careful dissection techniques, opens the anterior ethmoid cells and creates a wide communication with the frontal sinus;
A Draf IIa, IIb, or III frontal sinusotomy may be performed depending on case complexity;
Hemostasis is achieved through electrocoagulation or application of hemostatic materials;
A temporary stent may be placed to keep the sinus opening patent.

Recovery

Mild bleeding and nasal congestion may occur in the first few days;
Blowing the nose should be avoided for 10–14 days;
Saline nasal irrigation and regular ENT follow-ups are recommended (1–2 weeks post-op);
Physical exertion and exposure to dust or smoke should be avoided;
Full recovery typically occurs within 2–4 weeks, depending on the extent of the procedure.

Endoscopic frontal sinusotomy is an effective and safe procedure to restore frontal sinus function in cases unresponsive to medical treatment. The minimally invasive approach reduces complications, recovery time, and postoperative discomfort, offering excellent functional and cosmetic outcomes.

Sources:

https://pubmed.ncbi.nlm.nih.gov/15054372/

https://pubmed.ncbi.nlm.nih.gov/?term=endoscopic+frontal+sinusotomy

https://emedicine.medscape.com/article/862292-overview?form=fpf

https://www.ijhns.com/doi/pdf/10.5005/jp-journals-10001-1257

https://my.clevelandclinic.org/health/treatments/17478-functional-endoscopic-sinus-surgery