Background: The recent advances in imaging and endoscopic techniques have resulted in the resurgence of intranasal procedures for the treatment of frontal sinus disease.
Objective: This study aimed to compare the following parameters in patients undergoing endoscopic frontal sinus through intact bulla technique and classic technique regarding feasibility of the technique, operative time, success rate and complications.
Subjects and Methods: At Oto-Rhino-Laryngology, Department, Zagazig University Hospital, fifty patients with chronic frontal sinusitis resistant to medical treatment for a period not less than twelve weeks were included in this prospective clinical trial. The patients were divided into two groups: The first (the frontal sinus) group was approached by the classic approach from posterior to anterior, the second group, where the intact bulla technique was used to approach the frontal sinus. All the patients underwent ESS addressing their frontal sinus pathology.
Results: There was a statistically significant difference between the two surgical techniques regarding operative duration. Recurrence of symptoms occurred in one patient with intact bulla technique and one patient with the classic technique while frontal ostium restenosis occurred in one patient with intact bulla technique and two patients with the classic technique. Nasal adhesions occurred postoperative between inferior turbinate and septum in 3 sides only that were excised locally at outpatient clinic.
Conclusion: Addressing frontal sinus through intact bulla technique is less invasive and guards against anterior ethmoidal artery accidental injury during surgery.