Current issues in endoscopic endonasal surgery of the frontal sinuses

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. 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. 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: 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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