Transblepharoplasty approach to sequestered disease of the lateral frontal sinus with ophthalmologic manifestations

Thomas A. Knipe, Parag D. Gandhi, James Fleming, Rakesh K. Chandra

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Sequestered disease within the lateral extent of the frontal sinus that has eroded into the orbit through the frontal sinus floor may be difficult to address with standard ESS techniques. We describe an approach to this problem using a transblepharoplasty incision concealed in the upper eyelid crease. Methods: Five consecutive patients with lateral frontal sinus disease involving the orbit were treated with combined ESS/transblepharoplasty approach. This used an upper lid incision and elevation of a myocutaneous flap. The preexisting dehiscence in the sinus floor was exposed, permitting extraction of fungal debris and marsupialization of the mucocele. Frontal sinusotomy was performed via combined above/below technique Results: The study group included 5 patients with mean age of 50 years. Two patients had post-traumatic mucopyocele, two had allergic fungal sinusitis, and one exhibited both entities. All patients had signs of ophthalmopathy: proptosis with increased IOP (5/5), gaze restriction (5/ 5), and decrease in visual acuity (2/5). Ophthalmologic symptoms improved postoperatively in 5/5, but 2 patients eventually required revision endoscopic surgery. No complications occurred, and incision healing was excellent in all patients. Conclusion: In patients with sequestered disease of the lateral frontal sinus and ophthalmologic manifestations, the transblepharoplasty approach in combination with ESS affords excellent access while preserving cosmesis.

Original languageEnglish (US)
Pages (from-to)100-104
Number of pages5
JournalAmerican Journal of Rhinology
Volume21
Issue number1
DOIs
StatePublished - Jan 1 2007

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Transverse Sinuses
Frontal Sinus
Orbit
Mucocele
Myocutaneous Flap
Exophthalmos
Sinusitis
Eyelids
Reoperation
Visual Acuity

All Science Journal Classification (ASJC) codes

  • Otorhinolaryngology

Cite this

Transblepharoplasty approach to sequestered disease of the lateral frontal sinus with ophthalmologic manifestations. / Knipe, Thomas A.; Gandhi, Parag D.; Fleming, James; Chandra, Rakesh K.

In: American Journal of Rhinology, Vol. 21, No. 1, 01.01.2007, p. 100-104.

Research output: Contribution to journalArticle

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