Frontiers in Surgery (Apr 2022)

Precision Endonasal Endoscopic Surgery of the Frontal Recess Cells and Frontal Sinus Guided by the Natural Sinus Drainage Pathway

  • Zhouying Peng,
  • Zhouying Peng,
  • Zhouying Peng,
  • Zhouying Peng,
  • Yumin Wang,
  • Yumin Wang,
  • Yumin Wang,
  • Yumin Wang,
  • Yan Fang,
  • Yan Fang,
  • Yan Fang,
  • Yan Fang,
  • Yaxuan Wang,
  • Yaxuan Wang,
  • Yaxuan Wang,
  • Xiang Chen,
  • Xiang Chen,
  • Xiang Chen,
  • Ruohao Fan,
  • Ruohao Fan,
  • Ruohao Fan,
  • Ruohao Fan,
  • Hua Zhang,
  • Hua Zhang,
  • Hua Zhang,
  • Hua Zhang,
  • Zhihai Xie,
  • Zhihai Xie,
  • Zhihai Xie,
  • Zhihai Xie,
  • Weihong Jiang,
  • Weihong Jiang,
  • Weihong Jiang,
  • Weihong Jiang

DOI
https://doi.org/10.3389/fsurg.2022.862178
Journal volume & issue
Vol. 9

Abstract

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BackgroundThe endoscopic endonasal approach to removing lesions in the nasal cavity and sinuses has become the modern first choice. However, if endoscopic surgery is performed without proper knowledge of sinus anatomy, there is a risk of residual lesions, recurrence, and even serious complications. Therefore, this article illustrates the importance of precise sinus opening guided by the natural sinus drainage pathway, using the anatomy of the frontal sinus (FS) and the frontal recess (FR) cells as an example.MethodA total of 82 sides cadaveric heads were dissected and analyzed, and the natural drainage pathways of the FR cells and FS were observed at 0°and 70°nasal endoscopic views, and the findings were summarized. The data of 79 patients who accepted endonasal endoscopic surgery (EES) guided by natural sinus drainage pathways to remove mucoceles in our department from January 2015 to January 2021 were retrospectively analyzed.ResultsTwo natural drainage pathways of the FR cells were discovered, identified, and named the medial pathway of the FR (MPFR) and the lateral pathway of the FR (LPFR). The 79 patients who accepted EES to remove mucoceles through the natural drainage pathways of FR cells and the FS showed significant improvement in clinical symptoms, and none of them had recurrence after surgery without serious complications.ConclusionThe EES of the FR cells and FS through the natural drainage pathways to remove the mucoceles facilitates exposure of the cells without residual lesions and without serious complications.

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