Long-term stenting for chronic frontal sinus disease: case series and literature review

J Laryngol Otol. 2010 Nov;124(11):1216-22. doi: 10.1017/S0022215110001052. Epub 2010 May 20.

Abstract

Objective: The frontal sinus outflow tract consists anatomically of narrow channels prone to stenosis. Following both endonasal and external approach surgery, up to 30 per cent of patients suffer post-operative re-stenosis of the frontal sinus outflow tract, with recurrent frontal sinus disease. This paper proposes the surgical placement of a long-term frontal sinus stent to maintain fronto-nasal patency, as an alternative to more aggressive surgical procedures such as frontal sinus obliteration and modified Lothrop procedures.

Design: We present a series of three patients with frontal sinus disease and significant co-morbidity, the latter making extensive surgery a significant health risk. We also review the relevant literature and discuss the use of long-term frontal sinus stenting.

Results: These three cases were successfully treated with long-term frontal sinus stenting. Stents remained in situ for a period ranging from 48 to over 60 months.

Conclusion: Due to the relatively high failure rates for both endonasal and external frontal sinus surgery, with a high post-operative incidence of frontal sinus outflow tract re-stenosis, long-term stenting is a useful option in carefully selected patients.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Chronic Disease
  • Constriction, Pathologic
  • Endoscopy / adverse effects
  • Endoscopy / methods*
  • Female
  • Frontal Sinus / surgery*
  • Frontal Sinusitis / surgery
  • Humans
  • Male
  • Middle Aged
  • Otorhinolaryngologic Surgical Procedures / adverse effects
  • Otorhinolaryngologic Surgical Procedures / methods*
  • Paranasal Sinus Diseases / etiology
  • Paranasal Sinus Diseases / surgery*
  • Postoperative Care / methods
  • Recurrence
  • Stents*
  • Time Factors
  • Wound Healing / physiology