Prevention of frontal pocket stenosis after endoscopic transnazal surgery on the frontal sinus and endoscopic septoplasty in acute and chronic pathology of frontal sinuses

Abstract

To offer an effective method to prevent postoperative frontal recess stenosis after endoscopic endonasal frontal sinus surgery and surgical correction of intra-nasal structures. In our manuscript we analyzed 274 cases of endoscopic endonasal frontal sinus surgery: postoperative treatment (local and systemic). All of them were operated by endoscopic endonasal approach both initially and repeatedly for acute and chronic frontal sinusities in the ENT department Pavlov First state medical university of Saint Petersburg from 2013 to 2019. In 10 cases, patients with previous endoscopic endonasal frontal sinus surgery underwent revision endoscopic procedure due to frontal recess obstruction, in 4 cases - due to a recurrence of the polypous process involving the frontal sinus, in 6 cases - without visible provoking factors contributing to restenosis of the frontal recess. First step in all cases was a correction of the nasal septum. It is necessary to assess the factors that contribute to restenosis of the frontal recess. Careful endoscopic care of the nasal cavity and the frontal recess in the postoperative period can reduce the risk of restenosis of the latter. Local antibacterial nasal therapy is recommended for the prevention of purulent processes in the nasal cavity in the early postoperative period.