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Balloon sinuplasty is a tool that is used to treat selected patients with paranasal sinus pathologies. No studies have investigated the aetiology of failed access to the frontal sinus. The aim of our study was to specify the intraoperative technical failure rate and to analyse the aetiology of the failed access to predict potential technical difficulties before surgery. We retrospectively analysed the charts of patients who underwent balloon sinuplasty from November 2007 to July 2010 at three different ENT-Centres. CT-analysis of the patients with failed access was performed. Of the 104 frontal sinuses, dilation of 12 (12%) sinuses failed. The anatomy of all failed cases revealed variations in the frontal recess (frontoethmoidal-cell, frontal-bulla-cell or agger-nasi-cell) or osteoneogenesis. In one patient, a lymphoma was overlooked during a balloon only procedure. The lymphoma was diagnosed 6 months later with a biopsy during functional endoscopic sinus surgery. In complex anatomical situations of the frontal recess, balloon sinuplasty may be challenging or impossible. In these situations, it is essential to have knowledge of classical functional endoscopic sinus surgery of the frontal recess area. The drawbacks of not including a histopathologic exam should be considered in balloon only procedures.
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Bern, Switzerland, Freiburgstrasse, 3010, Bern, Switzerland.
This article was published in the following journal.
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A multi-center, non-randomized, prospective post-market evaluation of sinuplasty in paranasal sinuses.
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Air-filled spaces located within the bones around the NASAL CAVITY. They are extensions of the nasal cavity and lined by the ciliated NASAL MUCOSA. Each sinus is named for the cranial bone in which it is located, such as the ETHMOID SINUS; the FRONTAL SINUS; the MAXILLARY SINUS; and the SPHENOID SINUS.
One of the paired, but seldom symmetrical, air spaces located between the inner and outer compact layers of the FRONTAL BONE in the forehead.
Inflammation of the NASAL MUCOSA in the FRONTAL SINUS. In many cases, it is caused by an infection of the bacteria STREPTOCOCCUS PNEUMONIAE or HAEMOPHILUS INFLUENZAE.
An intracranial or rarely intraspinal suppurative process invading the space between the inner surface of the DURA MATER and the outer surface of the ARACHNOID. Bacteria and other pathogenic organisms may gain entrance to the subdural space from the FRONTAL SINUS; ETHMOID SINUS; middle ear (EAR, MIDDLE); MASTOID; or as the result of CRANIOCEREBRAL TRAUMA or NEUROSURGICAL PROCEDURES. This condition may be associated with intracranial sinus thrombosis (SINUS THROMBOSIS, INTRACRANIAL). Circumscribed collections of purulent material in the subdural space are referred to as subdural abscesses. (From Adams et al., Principles of Neurology, 6th ed, p709)
An irregular unpaired bone situated at the SKULL BASE and wedged between the frontal, temporal, and occipital bones (FRONTAL BONE; TEMPORAL BONE; OCCIPITAL BONE). Sphenoid bone consists of a median body and three pairs of processes resembling a bat with spread wings. The body is hollowed out in its inferior to form two large cavities (SPHENOID SINUS).