eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Nasal & Sinus Diseases

Sinusitis, Frontal, Acute, Surgical Treatment: Multimedia

Author: Priya Krishna, MD, Assistant Professor, Division of Laryngology, Department of Otolaryngology, University of Pittsburgh School of Medicine
Coauthor(s): Dennis Lee, MD, MPH, Director, Assistant Professor, Department of Otolaryngology, Division of Pediatric Otolaryngology, Southern Illinois University School of Medicine
Contributor Information and Disclosures

Updated: Feb 6, 2008

Multimedia

(A) Frontal sinus, (B) middle turbinate, (C) ethm...
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Media file 1: (A) Frontal sinus, (B) middle turbinate, (C) ethmoid bulla, (D) hiatus semilunaris, (E) uncinate process, and (F) superior turbinate.
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(A) Frontal sinus, (B) middle turbinate, (C) ethm...

(A) Frontal sinus, (B) middle turbinate, (C) ethmoid bulla, (D) hiatus semilunaris, (E) uncinate process, and (F) superior turbinate.

Axial section through right nasal cavity depicts ...
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Media file 2: Axial section through right nasal cavity depicts the following: (A) middle turbinate (or concha); (B) ethmoid bulla; (C) drainage sites for frontal sinus (3 shaded areas); (D) uncinate process; (E) nasolacrimal duct; (F) hiatus semilunaris; (G) basal lamella; (H) septal cartilage.
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Axial section through right nasal cavity depicts ...

Axial section through right nasal cavity depicts the following: (A) middle turbinate (or concha); (B) ethmoid bulla; (C) drainage sites for frontal sinus (3 shaded areas); (D) uncinate process; (E) nasolacrimal duct; (F) hiatus semilunaris; (G) basal lamella; (H) septal cartilage.

(A) Frontal sinus, (B) sphenoid sinus, (C) cut su...
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Media file 3: (A) Frontal sinus, (B) sphenoid sinus, (C) cut surface of the middle turbinate, (D) ethmoid bulla, and (E) hiatus semilunaris.
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(A) Frontal sinus, (B) sphenoid sinus, (C) cut su...

(A) Frontal sinus, (B) sphenoid sinus, (C) cut surface of the middle turbinate, (D) ethmoid bulla, and (E) hiatus semilunaris.

(A) Curved incision under eyebrow to periosteum, ...
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Media file 4: (A) Curved incision under eyebrow to periosteum, (B) underlying bone exposed by periosteal elevator, with burr holes created with small drill, (C) two small plastic tubes inserted for daily irrigation of the frontal sinus.
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(A) Curved incision under eyebrow to periosteum, ...

(A) Curved incision under eyebrow to periosteum, (B) underlying bone exposed by periosteal elevator, with burr holes created with small drill, (C) two small plastic tubes inserted for daily irrigation of the frontal sinus.

(A) Incision under brow extending about 1 cm belo...
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Media file 5: (A) Incision under brow extending about 1 cm below the medial palpebral (canthal) ligament, (B) medial orbital wall entered with removal of posterior edge of nasal process of maxilla and lacrimal and anterior portions of lamina papyracea, (C) removal of posterior ethmoid cells, (D) superiorly based mucoperiosteal flaps lining of new frontal nasal communication, intranasal tube into frontal sinus.
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(A) Incision under brow extending about 1 cm belo...

(A) Incision under brow extending about 1 cm below the medial palpebral (canthal) ligament, (B) medial orbital wall entered with removal of posterior edge of nasal process of maxilla and lacrimal and anterior portions of lamina papyracea, (C) removal of posterior ethmoid cells, (D) superiorly based mucoperiosteal flaps lining of new frontal nasal communication, intranasal tube into frontal sinus.

(A) Incision (above or below eyebrows), (B) super...
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Media file 6: (A) Incision (above or below eyebrows), (B) superiorly based skin flap, with use of template of frontal sinus and a cut through periosteum along the superior, medial, and lateral edges, (C) saw blade of sagittal plane saw used to make a beveled cut through bone with inferior hinge of intact periosteum, with a line of fracture of bone-periosteum flap, (D) osteotome used along cut edges to elevate bone-periosteum flap, (E) flap reflected downward to expose sinus (in this case, osteoma is seen in the sinus; otherwise, in frontal sinus disease, all mucosa of sinus must be removed).
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(A) Incision (above or below eyebrows), (B) super...

(A) Incision (above or below eyebrows), (B) superiorly based skin flap, with use of template of frontal sinus and a cut through periosteum along the superior, medial, and lateral edges, (C) saw blade of sagittal plane saw used to make a beveled cut through bone with inferior hinge of intact periosteum, with a line of fracture of bone-periosteum flap, (D) osteotome used along cut edges to elevate bone-periosteum flap, (E) flap reflected downward to expose sinus (in this case, osteoma is seen in the sinus; otherwise, in frontal sinus disease, all mucosa of sinus must be removed).

(A) After obliteration, the flap is returned, and...
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Media file 7: (A) After obliteration, the flap is returned, and the periosteum reapproximated with absorbable suture, (B) outline of extension of brow incision in bilateral frontal sinus disease, (C) coronal incision in female patient to obviate brow incision.
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(A) After obliteration, the flap is returned, and...

(A) After obliteration, the flap is returned, and the periosteum reapproximated with absorbable suture, (B) outline of extension of brow incision in bilateral frontal sinus disease, (C) coronal incision in female patient to obviate brow incision.

More on Sinusitis, Frontal, Acute, Surgical Treatment

Overview: Sinusitis, Frontal, Acute, Surgical Treatment
Workup: Sinusitis, Frontal, Acute, Surgical Treatment
Treatment: Sinusitis, Frontal, Acute, Surgical Treatment
Follow-up: Sinusitis, Frontal, Acute, Surgical Treatment
Multimedia: Sinusitis, Frontal, Acute, Surgical Treatment
References
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Further Reading

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Keywords

sinus infection, acute sinusitis, bacterial sinusitis, chronic sinusitis, acute frontal sinusitis, upper respiratory infection, sinusitis, ethmoid sinus, frontal sinus, nasal polyps, nasal tumor, septal deviation, nasal trauma, mucosal swelling, mucociliary clearance, rhinorrhea, sinus headache, Haemophilus influenzae, Streptococcus species, Moraxella catarrhalis, meningitis, brain abscess, epidural empyema, subdural empyema, cerebral empyema, preseptal cellulitis, orbital cellulitis, subperiosteal abscess, cavernous sinus thrombosis, Pott puffy tumor, sinocutaneous fistula, osteomyelitis, trephination, frontoethmoidectomy, endoscopic sinus surgery, mucoceles, pyoceles, Lynch approach, Killian method, Reidel method, cranioplasty, Lothrop technique, Chaput-Meyer technique, osteoplastic flap, obliteration of the frontal sinus, nasal endoscopy, functional endoscopic sinus surgery, sinus surgery

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Contributor Information and Disclosures

Author

Priya Krishna, MD, Assistant Professor, Division of Laryngology, Department of Otolaryngology, University of Pittsburgh School of Medicine
Priya Krishna, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, and Voice Foundation
Disclosure: Nothing to disclose.

Coauthor(s)

Dennis Lee, MD, MPH, Director, Assistant Professor, Department of Otolaryngology, Division of Pediatric Otolaryngology, Southern Illinois University School of Medicine
Dennis Lee, MD, MPH is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American Laryngological Rhinological and Otological Society, and American Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Eric Moore, MD, Residency Director, Assistant Professor, Department of Otorhinolaryngology/Head and Neck Surgery, Mayo Graduate School of Medicine
Eric Moore, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Cleft Palate/Craniofacial Association, and American Rhinologic Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Erik Kass, MD, Chief, Department of Clinical Otolaryngology, Associates in Otolaryngology of Northern VA
Erik Kass, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Association for Cancer Research, American Medical Association, and American Rhinologic Society
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Advanced Headache Intervention Consulting fee Consulting; Covidien Corp Consulting fee Consulting

 
 
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