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Endoscopic Lothrop Procedure Effective For Recalcitrant Frontal Sinusitis
A DGReview of :"Salvage frontal sinus surgery: the endoscopic modified lothrop procedure."
The Laryngoscope
02/14/2003
By James Adams
Endoscopic modified Lothrop procedure is effective for the short-term management of recalcitrant and complicated frontal sinusitis.
The procedure is an alternative to the osteoplastic flap with frontal sinus obliteration, which has the been the gold standard for recalcitrant frontal sinusitis, explains Dr Peter John Wormald from the Section of Otolaryngology Head and Neck Surgery at the Adelaide and Flinders Universities in Australia.
Dr Wormald conducted a prospective study of 83 consecutive patients who underwent the modified Lothrop procedure. Patients had undergone a mean of six previous sinus surgeries before the Lothrop procedure. Seventeen of the patients had previously undergone frontal sinus obliteration with mucocele formation.
A primary success rate of 93% was achieved after an average follow-up of 21.9 ± 6.1 months.
The 7% of patients in whom the procedure failed had developed frontal ostium stenosis. These patients underwent a revision modified Lothrop procedure. At the time of the last review, each of these patients had a patent frontal ostium, Dr Wormhald reports.
Twenty-five percent of the patients had recurrent symptoms that were medically managed. These symptoms included mucosal changes in nine patients who had previously diagnosed fungal sinusitis, recurrent frontal sinus infections in four patients, polyps in three patients with aspirin-sensitive asthma and previous polyps, and frontal pain with no radiologic evidence of disease in five patients.
None of the patients required an osteoplastic flap procedure.
Dr Wormhald concludes that the endoscopic modified Lothrop procedure is an effective alternative to the osteopathic flap for recalcitrant and complicated frontal sinusitis.
Larnygoscope 2003;113:2:276-283.
"Salvage frontal sinus surgery: the endoscopic modified lothrop procedure."
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