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Masters of Surgery Video Presentations

Rhinology/Allergy

Session: Masters of Surgery: Rhinology and Skull Base

Prevention of Frontal Sinus Ostium stenosis After Modified Lothrop Frontal Sinus Surgery for Severe Eosinophilic Chronic Rhinosinusitis

Sunday, September 29, 2024
8:42 AM – 8:49 AM EDT
Location: MBCC, 222
Disclosure(s):
Yasuyuki Hinohira, MD, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Koshiro Miura, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

So Watanabe, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

PROGRAM DESCRIPTION:

Objectives:
Endoscopic modified Lothrop (EMLP) frontal sinus surgery for refractory frontal sinus diseases such as eosinophilic chronic rhinosinusitis (ECRS) has come to be widely performed. However, postoperative frontal sinus ostium stenosis may occur due to tissue scarring and bone regeneration. Various flap techniques to prevent stenosis are reported but they are complicated, and their outcomes are not satisfied. We present a simple technique to preserve frontal sinus ostium patency after EMLP using silicon plate with cyanoacrylate glue as a non-biomedical adhesive.

Methods:
This preliminary retrospective report included 24 ECRS cases with asthma including 7 AERDs. 16 of 24 cases had a history of previous ESS.
EMLP was performed on all cases without intraoperative complications. Wedge-shaped silicon plate with slits inserted into frontal sinus ostium was adhered to the exposed bone surface using cyanoacrylate glue. Free mucosal flap was also used in 15 of 24 cases. Calcium alginate as nasal packing was used to support the plate. Calcium alginate was kept left for 1 week, and then was removed. The silicon plate was taken off 3 to 4 weeks postoperatively. All cases were periodically followed up over 1 year.

Results:
22 cases showed wide enough frontal sinus ostium patency without polyp recurrence after surgery. 2 cases showed stenosis due to early displacement of the silicon plate.

Conclusion:
Cyanoacrylate glue is known as a safe and non-biomedical adhesive for closing wounds. Our simple technique using silicon plate with cyanoacrylate glue showed usefulness for preserving frontal sinus ostium patency after EMLP although is still premature.

    Lead Presenter(s)

  • Yasuyuki Hinohira, MD, PhD

    Vice-president
    Department of Otolaryngology, Kamio Memorial Hospital
    Tokyo, Tokyo, Japan

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Presenter(s)

  • TM

    Tetsuya Monden, MD

    Physician
    Kamio Memorial Hospital
    Tokyo, Tokyo, Japan

    Disclosure information not submitted.

  • KM

    Koshiro Miura, MD

    Physician
    Kamio Memorial Hospital
    chiyoda-ku kandaawajicho, Tokyo, Japan

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • So Watanabe, MD

    Department Chief
    Department of Otolaryngology, Kohnodai Hospital, National Center for Global Health and Medicine
    Ichikawa, Chiba, Japan

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.