Resection of the interfrontal sinus septum in chronic or recurrent frontal sinusitis. Pre- and post-operative evaluation of the naso-frontal duct.

Abstract

In 9 patients with recurrent attacks of acute or chronic frontal sinusitis, interfrontal sinus septum resection was performed. In 5 patients there was unilateral disease and in 4 bilateral. As all patients had previously had their frontal sinus trephined, pre- and post-operative naso-frontal duct function tests were performed. Pre-operatively, of 11 naso-frontal ducts tested (2 patients bilaterally) not one showed air flow on spontaneous respiration. Passage of air was obtained at forced inspiration and expiration in one patient and by Valsalva's manoeuvre in 6. No flow of air whatsoever was obtained in 4 of the ducts, whatever the method used. At follow-up performed 1-8 years post-operatively 7 out of the 9 patients had no frontal sinus problems. The remaining 2 patients, who both had nasal allergy, were improved. Post-operative testing of the 9 patients showed flow of air on spontaneous respiration in 4 patients, whereas 4 needed forced inspiration or expiration and only one patient Valsalva's manoeuvre. The sinus septum resection, which is very simple to perform, is a good alternative to more extensive frontal sinus surgery but may be of less value in patients with nasal allergy.