Frontal Sinusotomy Procedure: What to Expect in this Frontal Sinus Surgery

Understanding Frontal Sinus Anatomy

The frontal sinus is a pair of paranasal sinuses above the eye sockets. It is filled with air and kept warm and moist by its mucosal lining. These air pockets are believed to lighten the mass of the skull and enhance speech resonance with the other paranasal sinuses. The frontal sinus pair is asymmetrical and separated by a septum.

The frontal nasal duct drains moisture into the nasal cavity, preventing it from clogging.

However, frontal sinusitis is one of the most common types of inflamed sinus. Its most common cause is a viral infection. However, bacterial infections, allergies, nasal polyps, and a deviated nasal septum can also cause it. 

The most common symptom of frontal sinusitis is pain around the eye or in the forehead, alongside sinusitis symptoms of nasal congestion and fever. 

This frontal sinus disease can also lead to complications, as the infection can spread to other body parts, such as the brain.

The Importance of Frontal Sinus Surgery

Frontal sinusotomy opens the frontal sinus openings to improve drainage and relieve sinus-related symptoms. This frontal sinus surgery becomes a beneficial surgical treatment for patients if:

  • Frontal sinusitis is not relieved by conservative treatment.
  • The patient is experiencing related complications.
  • Frontal sinusitis is caused by abnormal anatomical structures such as nasal polyps and deviated nasal septum.
  • The patient experiences recurring frontal sinusitis 3-4 times a year.
  • The frontal sinusitis is caused by fungal infection.

Techniques Used in Frontal Sinusotomy

Your doctor can perform frontal sinusotomy through a variety of procedures. Typically, these procedures are conducted endoscopically for minimal invasiveness and enhanced precision in treating the frontal sinus.

Endoscopic sinus surgery is a primary approach. It leverages specialized tools, including an endoscope—a slender instrument equipped with a light and camera—to navigate and treat sinus issues. This technique allows for targeted intervention while minimizing disruption to surrounding tissues.

Certain frontal sinusotomy techniques involve removing segments of cranial bones to widen the frontal sinus opening, facilitating improved drainage and ventilation. One example is the anterior ethmoidectomy. This type of surgery involves the surgical removal of infected ethmoid bone and tissue, widening the frontal sinus opening.

In cases where tissue collapse is a concern, a frontal sinus stent may be inserted to maintain the expanded opening and promote optimal airflow.

Another sinus surgery technique is called frontal sinuplasty. This surgical treatment entails inflating a tiny balloon within the frontal sinus opening to dilate and widen it, gently promoting improved sinus function.

In any of these procedures, the frontal sinus is drained to decongest the chambers. Any abnormal structures in the frontal sinus are also removed for better airflow.

Surgical Approach and Patient Comfort

In any frontal sinusotomy procedure, the patient will be administered with general anesthesia and local anesthesia for comfort. General anesthesia puts the patient to sleep for the surgery. Local anesthesia is injected near the frontal sinus. It assists patient recovery after surgery and is believed to offset deep pain pathways.

Recovery and Follow-Up Care

After the surgical procedure, post-operative care will involve in-office visits for debridement of crusts and clots to clear the openings while the sinus structures heal. Frontal sinus care is also provided through saline irrigation to keep the sinuses moist and prevent crusting. Your doctor will monitor your recovery and answer your questions and concerns.

Are you ready for a clearer frontal sinus and improved quality of life? Schedule an appointment at Puget Sound Sinus Center with Dr. Amy Anstead, our dedicated sinus specialist with decades of experience and expertise in skull-based surgeries.

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