Here we depict the use of powered instrumentation for cases in which frontal recess exploration has failed to relieve obstruction of the frontal sinus.
Anatomical view of the frontal sinus
Anatomical view of frontal sinus
Anatomy of the agger nasi, superior uncinate cells
Anatomy of the anterior ethmoid cell
The superior septum in the region between the two frontal recesses, anterior to the nasofrontal isthmus
Using the soft tissue shaver with a 40° or 60° blade
(RAD® 60 #18-84016) in the area of the frontal sinus floor between the two frontal recesses
An irrigated straight or 55° suction bur (RAD® 55 #18-83670) is used in the anterior face of the frontal recess on one side.
The nasal crest is removed and the frontal sinus is progressively opened.
With the posterior table under direct visualization, drilling proceeds to the midline and beyond.
The contralateral frontal recess and isthmus are opened and in communication with the frontonasal opening.
Medtronic Xomed RAD® 55 tip on handpiece
Round Bur
Medtronic Xomed RAD® 55 tip
Medtronic Xomed RAD® 40 tip
TriCut™ Blade
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Mini-Trephination and Irrigation of the Frontal Sinus
Patients with frontal sinus disease most commonly present to the otolaryngologist with pressure in the frontal region. Frontal sinus disease is suggested by abnormalities in the nasal frontal recess on nasal endoscopy and is confirmed with coronal CT scans.
Location of the frontal sinus
A skin incision is made to accommodate the drill guide.
Drilling through the front plate
Drill is removed and guide pin is inserted through the drill guide.
The drill guide is then removed, leaving the guide pin in the drilled hole.
An irrigation cannula slides over the guide pin.
A syringe of sterile saline and tubing are connected to the
cannula.
Irrigation
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Important Safety Information
