uzspbgmuУчёные записки Первого Санкт-Петербургского государственного медицинского университета имени академика И. П. ПавловаThe Scientific Notes of the Pavlov University1607-41812541-8807Academician I.P. Pavlov First St. Petersburg State Medical University10.24884/1607-4181-2025-32-3-31-41uzspbgmu-1151Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESПроблемы эндоскопической эндоназальной хирургии лобных пазух на современном этапеCurrent issues in endoscopic endonasal surgery of the frontal sinuseshttps://orcid.org/0000-0002-5866-8324МунтянВ. В.MunteanV. V.

Мунтян Валерия Викторовна, аспирант кафедры оториноларингологии Медицинского института

117198, Москва, ул. Миклухо-Маклая, д. 6

Muntеan Vаleria V., Postgraduate Student of the Department of Otorhinolaryngology

 6, Miklukho-Maklaya str., Moscow, 117198 

muntyan_v@pfur.ruhttps://orcid.org/0000-0003-2719-5031НерсесянМ. В.NersesyanM. V.

Нерсесян Марина Владиславовна, д-р мед. наук, доцент кафедры оториноларингологии Медицинского института

117198, Москва, ул. Миклухо-Маклая, д. 6

Nersesyan Marina V., Dr. of Sci. (Med.), Associate Professor of the Department of Otorhinolaryngology, Medical Institute

 6, Miklukho-Maklaya str., Moscow, 117198 

nermarina@yahoo.comhttps://orcid.org/0000-0003-3309-4683ПодадюкВ. И.PopadyukV. I.

Попадюк Валентин Иванович, доктор медицинских наук, профессор, декан Факультета непрерывного медицинского образования Медицинского института, зав. кафедрой оториноларингологии Медицинского института

117198, Москва, ул. Миклухо-Маклая, д. 6

Popadyuk Valentin I., Dr. of Sci. (Med.), Professor, Dean of the Faculty of Continuing Medical Education of the Medical Institute, Head of the Department of Otorhinolaryngology, Medical Institute

 6, Miklukho-Maklaya str., Moscow, 117198 

popadyuk_vi@pfur.ruРоссийский университет дружбы народов имени Патриса ЛумумбыРоссияPeoples’ Friendship University of Russia named after Patrice LumumbaRussian Federation2025161220253233141Copyright © Мунтян В.В., Нерсесян М.В., Подадюк В.И., 20252025Мунтян В.В., Нерсесян М.В., Подадюк В.И.Muntean V.V., Nersesyan M.V., Popadyuk V.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sci-notes.ru/jour/article/view/1151Цель

Цель. Проанализировать анатомические особенности строения лобных пазух и передних клеток решетчатого лабиринта, изучить существующие различные модификации эндоскопических операций на лобных пазухах, а также выявить актуальные проблемы и противоречия в этой области.

Методы и материалы

Методы и материалы. Проведен анализ современных публикаций, посвященных эндоскопической хирургии лобных пазух, с акцентом на классификации, техники и результаты операций, представленных в базах данных PubMed, Scopus, eLibrary. Выбор материала осуществлен по ключевым словам: «лобная пазуха», «эндоскопическая фронтотомия», «frontal recess anatomy», «frontal sinus surgery», «extended frontal sinus surgery», «Draf classification», «modified Lothrop procedure». Кроме этого, в обзор включены монографии и руководства по эндоскопической хирургии околоносовых пазух.

Результаты

Результаты. С появлением компьютерной томографии и эндоскопических технологий хирургия лобной пазухи значительно эволюционировала. Были разработаны различные методики, такие как операции Draf I, IIA, IIB, III и другие, которые позволили минимизировать травматичность, сократить время восстановления и улучшить результаты лечения. Однако остаются нерешенными проблемы, такие как рубцовый стеноз, остеонеогенез и отсутствие четких показаний для выбора объема хирургического вмешательства.

Заключение

Заключение. Несмотря на значительные достижения в эндоскопической хирургии лобных пазух, сохраняется необходимость дальнейших исследований для оптимизации хирургических подходов, улучшения долгосрочных результатов, а также стандартизации показаний к различным видам вмешательств.

The objective was to analyze the anatomical features of the structure of the frontal sinuses and the anterior ethmoid air cells, to study the existing various modifications of endoscopic surgeries on the frontal sinuses, as well as to identify current problems and controversies in this field.

Methods and materials

Methods and materials. We analyzed historical and modern publications devoted to endoscopic frontal sinus surgery, with emphasis on classifications, techniques and results of operations presented in PubMed, Scopus, eLibrary databases. The material was selected by keywords: «frontal sinus», «endoscopic frontotomy», «frontal recess anatomy», «frontal sinus surgery», «extended frontal sinus surgery», «Draf classification», «modified Lothrop procedure». In addition, monographs and manuals on sinus surgery are included in the review.

Results

Results. With the advent of computed tomography and endoscopic techniques, frontal sinus surgery has evolved significantly. Various techniques such as Draf I, IIA, IIB, III and other surgeries have been developed to minimize trauma, reduce recovery time and improve outcomes after surgical intervention. However, such pathology as stenosis of frontal recess, osteoneogenesis and lack of clear indications are remained challenging to make a right choice for particular surgical intervention.

Conclusion

Conclusion: Despite significant advances in endoscopic frontal sinus surgery, there remains a need for further research to optimize surgical approach in each particular case for improving long-term outcomes and standardize indications for different types of surgical interventions.

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The authors declare that there are no conflicts of interest present.