We review our experience treating patients with medically refractory frontal sinusitis that could not be relieved with endoscopic intranasal surgery alone. Fourteen combined external and intranasal endoscopic frontal sinusotomies were performed on a consecutive sample of 11 patients presenting over a 38-month period of study. Postoperative results were classified as cured, improved, unchanged, or worse, based on patient symptoms and physical findings. At a mean postoperative follow-up of 19 months (range 4-36), 100% of these patients had benefited from this technique (7 cured, 4 improved, 0 unchanged, 0 worse). There were no major complications and natural sinus physiology was preserved. We conclude that a combined external and endoscopic intranasal frontal sinusotomy is an effective alternative to frontal sinus obliteration.
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