""This book will be a valuable resource for novice surgeons approaching one of the most challenging anatomical subsites, since it provides a stepwise approach to understanding the anatomical background, the radiological aspects, and the broad spectrum of different surgical approaches to the frontal sinuses.The authors are to be congratulated for this masterpiece, which will become the gold standard for experts and beginners."" --Paolo Castelnuovo Edited by renowned rhinologists and skull base surgeons Christos Georgalas and Anshul Sama, this complete guide to frontal sinus surgery covers surgi.

• The Frontal Sinus: Surgical Approaches and Controversies
• MedOne Access Information
• Tittle Page
• Copyright
• Dedication
• Foreword
• Foreword
• Preface
• Acknowledgments
• Contributors
• Contents
• Videos
• Section I Anatomy of the Frontal Sinus and Frontal
  • 1 Developmental Bases of the Anatomy of the Frontal Sinus
    • 1.1 Introduction
    • 1.2 Frontal Sinuses and Ethmoid Lateral Masses have Different Evolutionary and Developmental Origins
      • 1.2.1 The Ethmoid Develops from the Olfactory Cartilaginous Capsule
      • 1.2.2 The Frontal Sinuses Pneumatize after Erythropoietic Bone Marrow Conversion into Fatty Marrow
    • 1.3 The Nitric Oxide “Story” of the Paranasal Sinuses Makes them Playa Role in Blood Oxygenation on Demand
    • 1.4 Pneumosinus Dilatans and Arrested Pneumatization Could Bear Witness to Sinus Development
      • 1.4.1 Pneumosinus Dilatans
      • 1.4.2 Arrested Pneumatization
    • 1.5 Conclusion
  • 2 Radiological Anatomy
    • 2.1 Introduction
    • 2.2 Lamina Papyracea
    • 2.3 Uncinate Process
    • 2.4 Floor of Olfactory Recess
    • 2.5 Agger Nasi Air Cell
    • 2.6 Accessory Air Cells
    • 2.7 Anterior Ethmoidal Artery
    • 2.8 Bulla Ethmoidalis
    • 2.9 Middle Turbinate
    • 2.10 Conclusion
  • 3 Applied Surgical Anatomy
    • 3.1 General Considerations
    • 3.2 Applied Anatomy for Endonasal Approaches
    • 3.3 Applied Anatomy for External Approaches
      • 3.3.1 Coronal Approach
      • 3.3.2 Transpalpebral Approach
    • 3.4 Blood Supply
    • 3.5 Innervation
    • 3.6 Anatomical Variations and Surgical Considerations
    • 3.7 Conclusions
• Section II Endoscopic Surgical Approaches to Frontal Sinus Disease
  • 4 Draf Frontal Sinusotomy I and IIa
    • 4.1 Indications
    • 4.2 Surgical Steps
    • 4.3 Tips and Tricks
    • 4.4 Case Examples
    • 4.5 Complications Management
    • 4.6 Conclusion
  • 5 Draf Frontal Sinusotomy IIb
    • 5.1 Indications
    • 5.2 Anatomy
    • 5.3 Surgical Steps
      • 5.3.1 Lateral Approach
      • 5.3.2 Median Approach
    • 5.4 Tips and Tricks
    • 5.5 Complications
  • 6 Extended Draf IIb and Other Modifications of the Lothrop Procedure
    • 6.1 Introduction
    • 6.2 Indications
    • 6.3 Surgical Steps
      • 6.3.1 Overview of Standard Draf IIb
    • 6.4 Modifications of the Standard Draf IIb Procedure
      • 6.4.1 Modified Hemi-Lothrop Procedure (Eloy IIC)
      • 6.4.2 Modified Mini-Lothrop Procedure (Eloy IID)
      • 6.4.3 Modified Subtotal-Lothrop Procedure (Eloy IIE)
      • 6.4.4 Modified Central-Lothrop Procedure (Eloy IIF)
    • 6.5 Tips and Tricks
    • 6.6 Case Examples
      • 6.6.1 Example 1
      • 6.6.2 Example 2
      • 6.6.3 Example 3
    • 6.7 Complications
      • 6.7.1 Recurrence and Chronic Scarring
      • 6.7.2 Cerebrospinal Fluid Leak
      • 6.7.3 Orbital Injury
      • 6.7.4 Anterior Ethmoid Artery Injury
  • 7 The Frontal Sinus Rescue Procedure
    • 7.1 Indications
    • 7.2 Surgical Steps
      • 7.2.1 Step 1
      • 7.2.2 Step 2
      • 7.2.3 Step 3
      • 7.2.4 Step 4
    • 7.3 Reverse Frontal Rescue Procedure
    • 7.4 Complications
    • 7.5 Tips and Tricks
    • 7.6 Conclusion
  • 8 Draf III (Endoscopic Modified Lothrop)— Inside-Out and Outside-In Approaches
    • 8.1 Indications
      • 8.1.1 Relative Contraindications
    • 8.2 Surgical Steps
    • 8.3 Lateral-to-Medial/Inside-Out Technique
    • 8.4 Outside-In/Medial-to-Lateral Technique
    • 8.5 Tips and Tricks
    • 8.6 Case Examples
      • 8.6.1 A Case of Allergic Fungal Rhinosinusitis with Fronto-orbital Mucocele
      • 8.6.2 A Case of Chronic Frontal Sinusitis with a High Posterior Frontal (Type 3) Cell
      • 8.6.3 A Case of Chronic Frontal Sinusitis—Riedel’s Procedure Reversal
    • 8.7 Postoperative Management
    • 8.8 Complications and their Management
      • 8.8.1 Skull Base Injury and Cerebrospinal Fluid Leak
      • 8.8.2 Hemorrhage
      • 8.8.3 Orbital Injury
      • 8.8.4 Skin Injury
      • 8.8.5 Stenosis of the Frontal Sinus Neo-ostium
  • 9 Transseptal Approach
    • 9.1 Background and CT Review
    • 9.2 Indications and Contraindications
    • 9.3 Advantages
    • 9.4 Disadvantages
    • 9.5 Surgical Steps
    • 9.6 Tips and Tricks
      • 9.6.1 Case Example
    • 9.7 Complications
  • 10 Endoscopic Endonasal Orbital Transposition for Lateral Frontal Sinus Lesions
    • 10.1 Indications
    • 10.2 Surgical Steps
    • 10.3 Tips and Tricks
    • 10.4 Case Example
    • 10.5 Complications
  • 11 The Role of Frontal Sinus in Anterior Skull Base Surgery and the Transcribriform Approach
    • 11.1 Indications
    • 11.2 Surgical Steps
    • 11.3 Tips and Tricks
    • 11.4 Complications
  • 12 Extended Endonasal Anterior Skull Base Approaches
    • 12.1 Indications
    • 12.2 Surgical Steps
      • 12.2.1 Principles
      • 12.2.2 Operative Setup
      • 12.2.3 Surgical Technique
      • 12.2.4 Reconstruction
      • 12.2.5 Postoperative Considerations
    • 12.3 Tips and Tricks
    • 12.4 Case Examples
      • 12.4.1 Esthesioneuroblastoma (Transcribriform Approach)
      • 12.4.2 Tuberculum Sellae Meningioma: Endoscopic Transtuberculum/Transplanum Approach
    • 12.5 Complications and Management
      • 12.5.1 Vascular Complications
      • 12.5.2 Cranial Nerve Injury
      • 12.5.3 Cerebrospinal Fluid Fistulas
      • 12.5.4 Postoperative Infection
      • 12.5.5 Other Complications
  • 13 Revision Endoscopic Frontal Sinus Surgery
    • 13.1 Introduction
    • 13.2 Indications
      • 13.2.1 Ongoing Mucosal Disease
      • 13.2.2 Incomplete Dissection
      • 13.2.3 Lateralization of the Middle Turbinate
      • 13.2.4 Scarring and Synechiae
      • 13.2.5 Neo-Osteogenesis
    • 13.3 Patient Selection
    • 13.4 Preoperative Planning
      • 13.4.1 Analyzing the Computed Tomography Imaging
      • 13.4.2 Computer-Assisted Navigation during Surgery
      • 13.4.3 Endoscopes and Equipment
    • 13.5 Choice of Procedure
    • 13.6 Surgical Steps
      • 13.6.1 The Axillary Flap Technique
      • 13.6.2 Frontal Sinus Mini-Trephine
    • 13.7 Specific Scenarios
      • 13.7.1 Retained Cells in the Frontal Recess or Extending into the Frontal Sinus (Draf I or International Classification of Extent of Endoscopic Frontal Sinus Surgery Grades 1–3)
      • 13.7.2 A Narrow Frontal Ostium and/or Extensive Supra Agger/Bulla Frontal Cells, or Ongoing Significant Burden of Disease (CRSwNP, Aspirin-Sensitive Asthma, Allergic Fungal Disease [Draf III/EFSS 6])
    • 13.8 Tips and Tricks
    • 13.9 Case Example
    • 13.10 Complications: Management
      • 13.10.1 Scarring and Restenosis
      • 13.10.2 Anterior Ethmoid Artery
      • 13.10.3 Orbital Injury
      • 13.10.4 Cerebrospinal Fluid Leak
  • 14 Complications of Frontal Sinus Surgery
    • 14.1 Introduction
    • 14.2 Epidemiology and Etiology
    • 14.3 Specific Complications of Endoscopic Approaches to the Frontal Sinus
      • 14.3.1 Failure to Accomplish the Specific Aim of the Procedure
      • 14.3.2 Pain
      • 14.3.3 Bleeding
      • 14.3.4 Infection
      • 14.3.5 Scar/Stenosis
      • 14.3.6 Mucocele Formation
      • 14.3.7 Anterior Skull Base Injury/Cerebrospinal Fluid Leak
      • 14.3.8 Orbital Injury
    • 14.4 Prevention of Complications
      • 14.4.1 Preoperative Planning
      • 14.4.2 Perioperative Technique
      • 14.4.3 Postoperative Care
  • 15 Delivery of Topical Therapy to the Frontal Sinus
    • 15.1 Introduction
    • 15.2 Basic Science Research on Topical Distribution to the Sinuses
    • 15.3 Clinical Research on Topical Distribution to the Sinuses
      • 15.3.1 Tips and Tricks
    • 15.4 Conclusion
  • 16 Postoperative Management: Dressings and Toilet
    • 16.1 Natural History of Sinus Ostia after Surgery
    • 16.2 Intranasal Packing
      • 16.2.1 Nonabsorbable Packs
      • 16.2.2 Absorbable Packings
    • 16.3 To Pack or Not to Pack
    • 16.4 Inert Stents
    • 16.5 Drug-Eluting Stents
    • 16.6 Postoperative Care
      • 16.6.1 Saline Irrigations
      • 16.6.2 Endoscopic Debridement
      • 16.6.3 Topical Treatments
    • 16.7 Conclusion
  • 17 Office-Based Frontal Sinus Procedures
    • 17.1 Indications
      • 17.1.1 Anatomic Considerations
      • 17.1.2 Patient Selection
      • 17.1.3 Frontal Sinusitis
      • 17.1.4 Frontal Mucoceles
      • 17.1.5 Nasal Polyps
    • 17.2 Surgical Steps/Anesthesia
    • 17.3 Postoperative Management and Procedures
      • 17.3.1 Nasal Irrigations and Topical Therapies
    • 17.4 Tips and Tricks
      • 17.4.1 Case Examples
    • 17.5 Controversies
      • 17.5.1 Balloon Catheter Dilation
    • 17.6 Emerging Technologies
    • 17.7 Conclusion
• Section III Open Surgical Approaches to Frontal Sinus Disease
  • 18 Mini- and Maxi-Trephines
    • 18.1 Indications
    • 18.2 Surgical Steps
    • 18.3 Tips and Tricks
    • 18.4 Case Example
    • 18.5 Complications
  • 19 Osteoplastic Flap Approach with and without Obliteration
    • 19.1 Indications
    • 19.2 Surgical Steps
      • 19.2.1 Osteoplastic Flap without Obliteration
      • 19.2.2 Osteoplastic Flap with Obliteration
    • 19.3 Tips and Tricks
    • 19.4 Complications: Management
    • 19.5 Conclusion
  • 20 Riedel’s Procedure and Cranialization of the Frontal Sinus
    • 20.1 Riedel’s Procedure
      • 20.1.1 Historic Perspective
      • 20.1.2 Indications
      • 20.1.3 Technique
    • 20.2 Cranialization of the FrontalSinus
      • 20.2.1 Historic Perspective
      • 20.2.2 Indications
      • 20.2.3 Technique
• Section IV Management of Specific Frontal Sinus Conditions
  • 21 Frontal Sinus Barosinusitis
    • 21.1 Epidemiology and Etiology
    • 21.2 Clinical Presentation and Investigations
    • 21.3 Management
    • 21.4 Case Example (Courtesy of Christos Georgalas)
  • 22 Frontal Sinus in Patients with Cystic Fibrosis
    • 22.1 Epidemiology and Etiology
    • 22.2 Clinical Presentation and Investigations
      • 22.2.1 Radiographic Abnormalities in Cystic Fibrosis and the Frontal Sinus
    • 22.3 Management
      • 22.3.1 Medical Therapy
      • 22.3.2 Nasal Saline Irrigations
      • 22.3.3 Corticosteroids
      • 22.3.4 Topical Antibiotics
      • 22.3.5 Oral Antibiotics
      • 22.3.6 Dornase Alfa
      • 22.3.7 Cystic Fibrosis Transmembrane Conductance Regulator modulators
      • 22.3.8 Surgical Therapy
      • 22.3.9 Endoscopic Approaches
    • 22.4 Complications: Management
  • 23 Pneumosinus Dilatans
    • 23.1 Introduction
    • 23.2 Epidemiology and Etiology
    • 23.3 Clinical Presentation and Investigations
    • 23.4 Diagnosis
    • 23.5 Management
    • 23.6 Complications
    • 23.7 Conclusion
  • 24 Frontal Sinusitis in Chronic Rhinosinusitis without Nasal Polyposis
    • 24.1 Introduction
    • 24.2 Epidemiology
    • 24.3 Pathophysiology
      • 24.3.1 Anatomic Factors
      • 24.3.2 Physiological Factors
    • 24.4 Management
      • 24.4.1 Medical Management
      • 24.4.2 Surgical Management
    • 24.5 Conclusion
  • 25 Frontal Sinus Surgery in CRSwNP, AFRS, and ASA Triad
    • 25.1 Epidemiology and Etiology
      • 25.1.1 Chronic Rhinosinusitis with Nasal Polyps
      • 25.1.2 Aspirin-Exacerbated Respiratory Disease
      • 25.1.3 Allergic Fungal Sinusitis
    • 25.2 Clinical Presentation and Investigations
      • 25.2.1 Chronic Rhinosinusitis with Nasal Polyps
      • 25.2.2 Aspirin-Exacerbated Respiratory Disease
      • 25.2.3 Allergic Fungal Sinusitis
    • 25.3 Management Overview
      • 25.3.1 Chronic Rhinosinusitis with Nasal Polyps
      • 25.3.2 Aspirin-Exacerbated Respiratory Disease
      • 25.3.3 Allergic Fungal Sinusitis
    • 25.4 Extent of Surgery and Outcomes
      • 25.4.1 Goals of Surgery
      • 25.4.2 Effect of Extent of Surgery on Outcomes for Maxillary and Ethmoid Sinuses
      • 25.4.3 Effect of Extent of Surgery on Outcomes for the Frontal Sinus
    • 25.5 Case Examples
      • 25.5.1 Samter’s Triad Successfully Managed with Draf IIa
      • 25.5.2 Samter’s Triad Only Controlled after Draf III
      • 25.5.3 Nasal Polyp Recurrence in Frontal Ostium Managed in the Office
      • 25.5.4 Allergic Fungal Sinusitis Presenting with Proptosis
    • 25.6 Complications
  • 26 Frontal Sinus Mucoceles
    • 26.1 Terminology
    • 26.2 Epidemiology
    • 26.3 Pathology
    • 26.4 Clinical Presentation
    • 26.5 Investigations
    • 26.6 Classification
    • 26.7 Management
    • 26.8 Outcomes
    • 26.9 Conclusion
  • 27 Frontoethmoidal Osteomas
    • 27.1 Epidemiology and Etiology
    • 27.2 Histology
    • 27.3 Clinical Presentation and Investigations
    • 27.4 Management
    • 27.5 Approaches for Frontoethmoidal Osteomas
      • 27.5.1 External Approaches
      • 27.5.2 Endoscopic Approaches
    • 27.6 Summary
    • 27.7 Case Examples
      • 27.7.1 Case 1
      • 27.7.2 Case 2
      • 27.7.3 Case 3
      • 27.7.4 Case 4
  • 28 Frontal Inverted Papilloma
    • 28.1 Epidemiology and Etiology
    • 28.2 Clinical Presentation and Investigations
    • 28.3 Management
    • 28.4 Case Examples
      • 28.4.1 Case 1
      • 28.4.2 Case 2
      • 28.4.3 Case 3
    • 28.5 Complications: Management
  • 29 The Frontal Sinus: Fibro-Osseous Lesions
    • 29.1 Fibrous Dysplasia
      • 29.1.1 Epidemiology and Etiology
      • 29.1.2 Clinical Presentation and Investigations
      • 29.1.3 Management
    • 29.2 Ossifying Fibroma
      • 29.2.1 Epidemiology and Etiology
      • 29.2.2 Clinical Presentation and Investigations
      • 29.2.3 Management
      • 29.2.4 Surgical Steps
      • 29.2.5 Consent
    • 29.3 Summary
  • 30 Malignant Disease Involving the Frontal Sinus
    • 30.1 Epidemiology and Etiology
    • 30.2 Clinical Presentation and Investigation
    • 30.3 Staging
    • 30.4 Management
    • 30.5 Case Example
    • 30.6 Complications: Management
    • 30.7 Tips and Tricks
  • 31 Acute Frontal Osteomyelitis: Intracranial and Orbital Complications
    • 31.1 Epidemiology and Etiology
      • 31.1.1 Epidemiology
      • 31.1.2 Etiology
    • 31.2 Clinical Presentation and Investigations
      • 31.2.1 Orbital Complications
      • 31.2.2 Intracranial Complications
      • 31.2.3 Osseous Complications
      • 31.2.4 Investigations
    • 31.3 Management
      • 31.3.1 Frontal Sinus Drainage Techniques
      • 31.3.2 Management of Orbital Complications
      • 31.3.3 Management of Intracranial Complications
      • 31.3.4 Management of Osseous Complications
    • 31.4 Case Examples
      • 31.4.1 Case 1: Subperiosteal Abscess (Contrast-Enhanced CT)
      • 31.4.2 Case 2: Orbital Abscess (Magnetic Resonance Imaging)
      • 31.4.3 Case 3: Cerebral Abscess (Magnetic Resonance Imaging)
      • 31.4.4 Case 4: Epidural Abscess (Contrast-Enhanced CT)
      • 31.4.5 Case 5: Subdural Abscess (Contrast-Enhanced CT)
      • 31.4.6 Case 6: Pott’s Puffy Tumor
  • 32 Fungal Frontal Sinusitis: Allergic and Nonallergic
    • 32.1 Introduction
    • 32.2 Epidemiology and Etiology
      • 32.2.1 Invasive
      • 32.2.2 Noninvasive
    • 32.3 Clinical Presentation and Investigations
      • 32.3.1 Invasive
      • 32.3.2 Noninvasive
      • 32.3.3 Special Considerations in Frontal Sinus Fungal Disease
    • 32.4 Management
      • 32.4.1 Medical Management
      • 32.4.2 Surgical and Postoperative Management in the Frontal Sinus
      • 32.4.3 Complications: Management
    • 32.5 Conclusion
  • 33 Frontal Sinus Trauma and Its Management
    • 33.1 Epidemiology and Etiology
      • 33.1.1 Anatomy
      • 33.1.2 Trauma Mechanism
    • 33.2 Clinical Presentation and Investigations
      • 33.2.1 Initial Examination of the Patient
      • 33.2.2 Imaging and Paraclinical Investigations
    • 33.3 Management
      • 33.3.1 Surgical Techniques
      • 33.3.2 Surgical Decision-Making
    • 33.4 Case Example
    • 33.5 Complications: Management
  • 34 Cerebrospinal Fluid Leak in the Frontal Sinus: Endoscopic Management
    • 34.1 Epidemiology and Etiology
      • 34.1.1 Etiologies
    • 34.2 Clinical Presentation and Investigations
    • 34.3 Management
      • 34.3.1 Surgical Management
      • 34.3.2 Endoscopic versus Open Repair
      • 34.3.3 Postprocedural Care
      • 34.3.4 Postprocedural Adjuvants
      • 34.3.5 Outcomes
    • 34.4 Case Examples
    • 34.5 Complications: Management
    • 34.6 Conclusion
• Section V Controversial Topics in Current Practice
  • 35 The Use of Flaps in Frontal Sinus Surgery
    • 35.1 Published Evidence
      • 35.1.1 Background
      • 35.1.2 Rationale for Flaps
      • 35.1.3 Literature Review and Surgical Techniques
    • 35.2 Controversies and Opinions
      • 35.2.1 Promising Outcome for Flaps
      • 35.2.2 Recommendation for Future Studies
      • 35.2.3 Flaps Feasibility
      • 35.2.4 Illustrative Cases
    • 35.3 Surgical Tips
    • 35.4 Unanswered Questions
  • 36 Osteitis and the Frontal Sinus
    • 36.1 Introduction
    • 36.2 Epidemiology and Etiology
      • 36.2.1 Definitions
      • 36.2.2 Histology: Pathophysiology
      • 36.2.3 Allergy
      • 36.2.4 Bacteriology
      • 36.2.5 Biofilms
      • 36.2.6 Incidence
    • 36.3 Clinical Presentation and Investigations
      • 36.3.1 Radiological Features
      • 36.3.2 Clinical Implications
      • 36.3.3 Prognostic Factor
    • 36.4 Management
    • 36.5 Case Example
    • 36.6 Summary
    • 36.7 Key Points
  • 37 Extreme Lateral Lesions: What Is the Limit of Endoscopic Surgery?
    • 37.1 Published Evidence
      • 37.1.1 Traditional External Approaches for Far Lateral Lesions
      • 37.1.2 Endonasal Endoscopic Surgery and Evolution of Lateral Disease Management
      • 37.1.3 Evolution of Far Lateral Frontal Sinus Surgery: Exploring Limits of ESS
    • 37.2 Controversies and Opinions
    • 37.3 Unanswered Questions
  • 38 Use of Image Guidance Technology: Mandatory or Not
    • 38.1 Introduction
      • 38.1.1 Indications
      • 38.1.2 Applications
    • 38.2 Published Evidence
      • 38.2.1 Complications
      • 38.2.2 Revision Rate
      • 38.2.3 Clinical and Quality-of-Life Outcomes
      • 38.2.4 Medicolegal Concerns
      • 38.2.5 Cost
    • 38.3 Controversies and Opinions
      • 38.3.1 Indications
      • 38.3.2 Surgical Training
      • 38.3.3 Future Use
    • 38.4 Unanswered Questions
  • 39 Balloon Technology in the Frontal Sinus: Useful or Gimmick
    • 39.1 Published Evidence
      • 39.1.1 Level 1 Evidence
      • 39.1.2 Nonrandomized Studies
    • 39.2 Controversies and Opinions
      • 39.2.1 Diffuse versus Localized CRS
      • 39.2.2 Polyp Disease
      • 39.2.3 Miscellaneous Uses
      • 39.2.4 Contraindications
      • 39.2.5 Preoperative Preparation
      • 39.2.6 Training Requirements
      • 39.2.7 Complications
    • 39.3 Unanswered Questions
      • 39.3.1 Cost-Effectiveness
      • 39.3.2 Extrapolation to Wider Patient Cohort
  • 40 Minimum versus Maximal Surgical Sinusotomy
    • 40.1 Published Evidence
      • 40.1.1 Balloon Dilation
      • 40.1.2 Draf I
      • 40.1.3 Draf IIa
      • 40.1.4 Draf IIb
      • 40.1.5 Draf III
    • 40.2 Controversies and Opinions
    • 40.3 Case Studies
      • 40.3.1 Case 1
      • 40.3.2 Case 2
      • 40.3.3 Case 3
    • 40.4 Unanswered Questions
  • 41 Patient-Reported Outcome Measures and Outcomes in Frontal Sinus Surgery: Do They Make a Difference?
    • 41.1 Published Evidence
      • 41.1.1 Patient-Reported Outcome Measures in Rhinology
      • 41.1.2 Patient-Reported Outcome Measures in Frontal Sinus Treatment
    • 41.2 Controversies and Opinions
    • 41.3 Unanswered Questions
  • 42 Symptoms of Frontal Sinus Disease: Where Is the Evidence?
    • 42.1 Published Evidence
    • 42.2 Controversies and Opinions
    • 42.3 Case Examples
      • 42.3.1 Case 1
      • 42.3.2 Case 2
      • 42.3.3 Case 3
      • 42.3.4 Case 4
      • 42.3.5 Case 5
    • 42.4 Unanswered Questions
  • 43 Anatomy and Classification of Frontoethmoidal Cells
    • 43.1 Introduction
    • 43.2 Published Evidence
    • 43.3 Controversies and Opinions
  • 44 To Drill or Not to Drill
    • 44.1 Published Evidence
    • 44.2 Indications for Drilling Approaches of the Frontal Sinus
    • 44.3 Results of Drilling Approaches of the Frontal Sinus
    • 44.4 Complications
    • 44.5 Controversies and Opinions
    • 44.6 Unanswered Questions
  • 45 Indications for Operating the Frontal Sinus: Primary Surgery or Always Second Line?
    • 45.1 Introduction
    • 45.2 Controversies and Opinions
      • 45.2.1 Does OMC/Frontal Recess Obstruction Cause Frontal CRS?
      • 45.2.2 Is Anterior Ethmoidectomy (Draf I) Optimal as First-Line Surgery for Frontal CRS?
      • 45.2.3 What Are the Clinical Characteristics of Patients Who Fail Draf I?
      • 45.2.4 Why Is Draf I not Successful in Some Patients with Frontal CRS?
      • 45.2.5 Is Primary Draf IIa Effective as an Initial Surgical Intervention for Frontal CRS?
    • 45.3 Case Studies
      • 45.3.1 Case 1: Mild Diffuse CRSwNP Involving the Frontal Sinus
      • 45.3.2 Case 2: Failed Draf I Procedure Requiring at least Draf IIa—Ciliary Dysfunction?
      • 45.3.3 Case 3: Severe CRSwNP Requiring EMLP as Initial Surgical Intervention
      • 45.3.4 Case 4: Odontogenic Frontal CRS
    • 45.4 Unanswered Questions
  • 46 Economic and Quality-of-Life Evaluation of Surgery and Medical Treatment for Chronic Rhinosinusitis
    • 46.1 Published Evidence
      • 46.1.1 What is Known about the Economic Burden of Chronic Rhinosinusitis
      • 46.1.2 What Are the Wider Costs of CRS?
      • 46.1.3 What Is the Impact of CRS on QOL?
      • 46.1.4 Cost and Cost-Effectiveness of Treatment for CRS
    • 46.2 Controversies Surrounding the Cost-Effectiveness of Treatment for CRS
    • 46.3 Unanswered Questions and Future Research
  • 47 Training Models and Techniques in Frontal Sinus Surgery
    • 47.1 Introduction
    • 47.2 Published Evidence
    • 47.3 Controversies and Opinions
    • 47.4 Unanswered Questions
  • 48 Augmented Reality in Frontal Sinus Surgery
    • 48.1 Role of Augmented Reality in Preoperative Planning
    • 48.2 Role of Augmented Reality during Surgery
  • 49 Robotic Surgery: Beyond DaVinci
    • 49.1 Published Evidence
      • 49.1.1 Shortcomings of DaVinci
    • 49.2 Steering at Greater Simplicity
    • 49.3 Steering at Reduced Dimensions
    • 49.4 Controversies and Opinions
      • 49.4.1 Maneuvering beyond DaVinci
    • 49.5 Maneuvering Like a Snake
    • 49.6 Future Steps toward Clinical Practice
    • 49.7 Unanswered Questions
  • 50 Pathophysiology of the Failed Frontal Sinus and Its Implications for Medical Management
    • 50.1 Introduction
    • 50.2 Failure due to Errors in Patient Selection
    • 50.3 Local Causes of Recalcitrant Frontal Sinus Disease
    • 50.4 Systemic Causes of Recalcitrant Frontal Sinus Disease
    • 50.5 Conclusion
• Index
• Additional MedOne Access Information