Reliably Deploying the Workhorse: Optimizing the Draf 2A Technique in Primary and Revision Frontal Surgery

PROGRAM DESCRIPTION: The Draf 2a procedure clears all ethmoidal cells above and below the frontal ostium, providing for a wide functional frontal sinus outflow tract. The technique facilitates reliable success in the primary setting and allows for successful revision frontal surgery in most patients, without the need for the more invasive Draf 3/endoscopic modified Lothrop procedure. Incomplete dissection of ethmoidal cells is a common finding during revision frontal sinus surgery, and the Draf 2a is likely the most common procedure performed in these revision frontal sinus surgery settings. In addition to mucosal preserving comprehensive dissection, postoperative debridement and care are essential components of success. Mastery of the Draf 2a technique and postoperative care is an essential skill set for the contemporary comprehensive otolaryngologist. This presentation will specifically address fundamental principles and strategies for optimizing the workhorse Draf 2a procedure for use in primary and revision settings. We will also illustrate indications of adjunctive techniques such as stenting, Draf 2b, frontal trephination, and nasal beak removal. In addition, postoperative care and debridement strategies will be outlined.

This year’s presentation is modified from our highly rated prior frontal surgery courses to focus on Draf 2a procedures to target the needs of comprehensive otolaryngologists interested in building expertise in frontal surgery. The presenters are expert frontal surgeons with an experienced lead presenter and a fellowship-trained early faculty.