This bony lamella was subsequently penetrated resulting in a large outflow of retained purulent secretions. This lamella was completely taken down resulting in excellent ventilation of the entire right frontal sinus. As in the vast majority of cases, nasal packing was not required at the conclusion of the case. Without the aid of the image-guidance system, we may not have proceeded further after initially widening the nasofrontal recess, which would have resulted in incomplete ventilation of the right frontal sinus and persistence of the patient's symptoms. Chronic rhinosinusitis results in many symptoms that can make our patients miserable.
Treatment requires aggressive long-term medical therapy and often requires surgical intervention.
Endoscopic minimally invasive sinus surgery has decreased morbidity and recovery times and can have dramatic results in properly selected patients. Frontal sinusitis is the most challenging to approach surgically and has traditionally required open surgical procedures, which increase morbidity and recovery time and may require facial incisions. The Nasal and Sinus Disorders Program approaches the vast majority of frontal sinusitis cases endoscopically, allowing for reduced morbidity to the patient and quick recovery times. A review of our experience in 30 patients with chronic frontal rhinosinusitis who underwent endoscopic frontal sinus surgery using an image-guidance system reveals the utility of the system. The intraoperative imaging system was used as an adjunct to operative experience and a thorough knowledge of sinus anatomy, especially in the anterior ethmoid and nasofrontal duct regions.