Frontal ostium neo-osteogenesis and patency after Draf III procedure: a computer-assisted study.

Abstract

Stenosis of the frontal neo-ostium after Draf III procedure has been associated with inflammatory risk factors. However, the degree to which neo-osteogenesis contributes to postsurgical stenosis of the frontal neo-ostium is unclear. Twenty-five patients with chronic frontal sinusitis who underwent Draf III procedure and had been followed for at least 12months were included. Paranasal sinus computed tomography (CT) scans were performed 7days and 1year postoperatively. The frontal neo-ostium cross-sectional area and the amount of frontal neo-osteogenesis were measured by a standardized protocol using triplanar radiologic viewing software. Association between the severity of frontal neo-osteogenesis and the patency of the neo-ostium was analyzed, as was the correlation between the extent of neo-osteogenesis and the preoperative Global Osteitis Scoring Scale (GOSS), Lund-Mackay score (LMS), Lund-Kennedy score (LKS), serum eosinophil count, and history of previous surgery. At 1year postoperatively, significant inverse correlation was found between the size of the frontal neo-ostium and the extent of neo-osteogenesis. According to a multiple linear regression model, the severity of neo-osteogenesis was positively correlated with preoperative GOSS and negatively correlated with asthma (p < 0.05). Additionally, there was no association between extent of neo-osteogenesis and the preoperative LMS, LKS, serum eosinophil count, and history of previous surgery. Neo-osteogenesis has a significant impact on the patency of the frontal neo-ostium but appears unrelated to inflammatory factors. Patients with a higher risk for developing neo-osteogenesis can be identified preoperatively based on GOSS; these patients may benefit from closer monitoring during the follow-up period.