The history of frontal sinus surgery was first delineate in 1750. Despite over two centuries since the outline of the procedure on sinus, the best procedure remains not clear. Sinus malady may be extremely morbid with the danger of life threatening complications, due to its anatomic proximity to anterior os base and orbit.
“Surgical treatment of chronic frontal redness is tough, usually unsatisfying and typically disastrous” Ellis 1954.
Aims of ideal treatment modality of this malady are:
Eradication of underlying malady method
Preservation of operate of the sinus
To cause least morbidity and cosmetic deformity.
Historically the perfect surgery has been flip flopping from External to intranasal. With the recent advancement in imaging techniques and nasal endoscopes, examination sinus surgery is turning into extremely common currently. Resolution and details provided by trendy imaging modalities have gone a protracted method in reducing the potential surgical complications of examination surgery.
History of surgical procedures involving this space may be divided into following era:
History of Frontal Sinus - Era of operation (1750):
Frontal sinus surgery was initial delineate in 1750. it had been in 1884 Alexander Ogstun delineate a operation procedure wherever a gap was created within the anterior table of sinus to evacuate the sinus cavity. He additionally expanded the naso frontal duct and curetted its membrane. He believed this procedure may facilitate higher drain from the sinus. He advocated placement of drain tube within the naso frontal duct to forestall pathology.
It was concerning constant time Luc delineate the same procedure. This procedure was capably referred to as Ogstun Luc procedure. This procedure failing normally due to accrued incidence of nasofrontal duct pathology.
History of Frontal Sinus - Era of radical ablation procedures (1895):
Kuhnt in 1895 delineate a procedure wherever in he removed the anterior wall of this sinus in an effort to clear the sinus of the morbid membrane. He stripped the membrane up to the frontal recess and stented the frontonasal duct to boost the drain. In 1898 Riedel performed obliteration of the sinus. He advocated complete removal of anterior table and floor of FS with uncovering of membrane. He performed this procedure during a patient with osteitis of forehead. This procedure caused associate degree ugly deformity of os. Killian in one903 advocated retention of 1 cm bar of cavum rim. Killian was ready to avoid deformity by holding this bar of bone. Killian additionally advocated ethmoidectomy combined with rotation of tissue layer flap to hide the frontal recess space. Killian’s procedure was fraught with complications like Restenosis, cavum rim mortification, post op infectious disease, mucocele formation etc.
History of Frontal Sinus - Era of conservative procedures (1905):
Major advantage of conservative procedure is rejection of cosmetic defects. Conservative procedures concerned intranasal approach to sinus. it had been Knapp in 1908 WHO performed external Fronto os surgery. He approached the FS through its floor, removed the morbid membrane and stented the Fronto nasal duct to forestall Restenosis.
In 1908 Halle-an-der-Saale well-defined out the frontal method of upper jawbone and used a burr to get rid of the ground of FS.
In 1914 Lothrop enlarged the drain pathway victimization intranasal approach. He combined intranasal ethmoidectomy with external ethmoidal approach. He managed to form a standard frontal nasal communication by removing the sinus floor, intersinus septum and also the superior portion of septum. He additionally aforementioned that surgical procedure of medial orbital wall caused prolapse of orbital contents into the os space inflicting obstruction to sinus drain.
History of Frontal Sinus - External frontoethmoidectomy 1897 – 1921:
In 1897 Jenson performed the primary external Fronto ethmoidectomy in Federal Republic of Germany. kill and Howarth in 1921 popularized surgical procedure of floor of the sinus with dilatation of the sinus outlet via external approach. This approach is therefore referred to as kill Howarth procedure. A curved incision is created slightly below the medial finish of hair. it’s ee medial to the medial corner. The frontal method of upper jawbone and plate papyracea is removed. The sinus is entered via its floor and also the lining membrane is curetted. A tube is placed within the sinus ostium to forestall pathology. The tube is left in situ for a amount of four weeks. Boyden used siloxane tube to forestall pathology.
History of Frontal Sinus - Osteoplastic anterior wall approach (1058):
This procedure became common throughout 1960′s. angel introduced photography plate to stipulate the sinus. This procedure was fraught with the danger of hemorrhage.
History of Frontal Sinus - Endoscopic intranasal approach:
With the appearance of nasal endoscopes (angled) approach to the sinus outflow tract has become simple.