Anterior frontal sinus resection

Frontal anterior wall resection is one of the surgical treatments for the treatment of chronic frontal sinusitis. Treatment of diseases: chronic frontal sinusitis Indication 1. After the frontal sinus drainage, acute inflammation has been controlled, but the lesion has not been cured. 2. Repeated acute exacerbation of chronic frontal sinusitis, treatment by drugs, catheter irrigation, nasal frontal tube expansion, etc., or has formed a pupil in the inferior frontal wall of the frontal sinus. 3. Frontal sinusitis causes intraorbital or intracranial complications. 4. Frontal sinus cyst, osteoma or foreign body, necessary for surgery. Preoperative preparation Shave the affected eyebrows and trim the nose hair. The same amount of sinus drainage. Surgical procedure 1. Supine position. Apply antibiotic eye ointment to the side of the operation and suture one eyelid. 2. From the lower edge of the lower edge of the eyebrow, inward along the upper edge of the iliac crest, then bend down, about 5 to 6 mm from the medial malleolus, and cut at about 1 cm below the medial malleolus for deep bone. 3. Peel the periosteum with the stripper to expose the bottom wall of the frontal sinus, the anterior wall and the lateral wall of the eyelid. If the artery is ligated before the sieving, or by a bipolar coagulator. 4. Use a round chisel or electric drill to make an opening in the anterior wall of the frontal sinus. Then use a rongeur to bite part of the anterior wall bone and enlarge the opening to expose the sinus lesion. If the original pupil exists, you can pass this. Expand into the frontal sinus. 5. Use the stripper and the curette to completely peel off the sinus mucosa and the diseased tissue, and remove it. If the posterior wall bone has been absorbed and damaged, and the sinus mucosa directly adheres to the dura mater, the mucosa should not be forcibly peeled off. So as not to damage the dura mater. If there is pain during peeling, 1% procaine can be injected submucosally. 6. Use the probe to probe into the nasal cavity through the nasal frontal tube, and extend the frontal sinus bone face forward, and extend in the direction of the probe to enlarge the big nose tube. If the nasal frontal tube is occluded, the bone can be opened in the medial side of the frontal sinus floor and communicated with the middle nasal passage to form a nasal forehead. If necessary, the frontal ridge can be used to enlarge. 7. Take a silicone tube with a length of about 8 mm and a diameter of about 0.6 cm. Open a small hole on the side of the upper section. The enlarged frontal tube from the frontal sinus is taken out from the nasal cavity. The excess part of the tube is cut off so that the front end exposes the front nostril about 1 cm. Wear a pin on it for easy attachment and to prevent the tube from coming out or retracting. The nose is clogged with antibiotic ointment gauze or iodoform gauze. 8. Separate the incision in two layers. Remove the eyelid suture and compress it slightly.

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