Combined Free Inferior Turbinate Mucosal Grafting with Silastic Sheet Stenting for the Prevention of Restenosis in Extended Frontal Sinus Surgery

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  • Ishino Takashi
    Department of Otorhinolaryngology, Head and Neck Surgery Graduate School of Biomedical and Health Sciences, Hiroshima University
  • Kawasumi Tomohiro
    Department of Otorhinolaryngology, Head and Neck Surgery Graduate School of Biomedical and Health Sciences, Hiroshima University
  • Takahara Daisuke
    Department of Otorhinolaryngology, Head and Neck Surgery Graduate School of Biomedical and Health Sciences, Hiroshima University
  • Nishida Manabu
    Department of Otorhinolaryngology, Head and Neck Surgery Graduate School of Biomedical and Health Sciences, Hiroshima University
  • Sonoyama Toru
    Department of Otorhinolaryngology, Head and Neck Surgery Graduate School of Biomedical and Health Sciences, Hiroshima University
  • Takemoto Kouta
    Department of Otorhinolaryngology, Head and Neck Surgery Graduate School of Biomedical and Health Sciences, Hiroshima University
  • Kono Takashi
    Department of Otorhinolaryngology, Head and Neck Surgery Graduate School of Biomedical and Health Sciences, Hiroshima University
  • Taruya Takayuki
    Department of Otorhinolaryngology, Head and Neck Surgery Graduate School of Biomedical and Health Sciences, Hiroshima University
  • Hamamoto Takao
    Department of Otorhinolaryngology, Head and Neck Surgery Graduate School of Biomedical and Health Sciences, Hiroshima University
  • Ueda Tsutomu
    Department of Otorhinolaryngology, Head and Neck Surgery Graduate School of Biomedical and Health Sciences, Hiroshima University
  • Takeno Sachio
    Department of Otorhinolaryngology, Head and Neck Surgery Graduate School of Biomedical and Health Sciences, Hiroshima University

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Other Title
  • 拡大前頭洞手術における遊離下鼻甲介粘膜 graft とシリコンシート留置の有用性
  • カクダイ ゼントウドウ シュジュツ ニ オケル ユウリ カ ビ コウカイネンマク graft ト シリコンシート リュウチ ノ ユウヨウセイ

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Abstract

<p>　One of the major factors influencing the success of extended frontal sinus surgery is the degree of success in covering the exposed bone surface in the neo-ostium. As compared to pedicle flaps, free inferior turbinate mucosal grafts (free IT grafts) supported with silastic sheet stents allow both free positioning and a good stability at the exposed bone surface, including the anterior margin of the neo-ostium. In this report, we outline the endoscopic modified Lothrop procedure (EMLP) (Draf type III) for covering the exposed bone surface in the neo-ostium using free IT grafts supported with silastic sheet stents, and the postoperative results over a follow-up period of 12 months. The EMLP (Draf type III) using the free IT grafts supported with silastic sheet stents was performed in patients with chronic rhinosinusitis, including eosinophilic chronic rhinosinusitis, by the same surgeon, from September 2016 to June 2018. We reviewed the data of 8 patients who were followed-up for 12 months after the surgery and evaluated the degree of preservation of the neo-ostium. The grafts were well-integrated into the neo-ostium in all patients, and the neo-ostium was also well-preserved, showing a horseshoe shape, in all patients, except for a patient with a massive recurrence of polyps. No complications, including synechiae formation in the inferior turbinate, were seen in any of the 8 patients. The EMLP (Draf type III) using free IT grafts supported with silastic sheet stents allows the shape of the neo-ostium to be maintained. This procedure appears to be a useful method to preserve the neo-ostium, similar to other grafts and pedicle flap techniques.</p>

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