Department of Surgical Science, University of Pavia, Pavia, Italy.
Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Acta Otorhinolaryngol Ital. 2023 Apr;43(Suppl. 1):S34-S40. doi: 10.14639/0392-100X-suppl.1-43-2023-04.
To retrospectively review the experience of five tertiary-care university hospitals on frontal sinus revision surgery with osteoplastic flap (OPF).
Descriptive analysis of patients who underwent frontal sinus surgery with OPF after one or more endoscopic procedures for benign and inflammatory pathologies from 2000 to 2022. Clinical charts were reviewed for demographics, indications, clinical presentation, previous frontal procedures, OPF technique and outcomes.
Of the 124 patients who underwent an OPF procedure, 33 met inclusion criteria. With a mean of 2.1 previous endoscopic surgeries, Draf III was the most common former procedure. In 30 (91%) cases OPF was part of a combined procedure. The most common indications were inverted papilloma (61%), mucocele (9%) and chronic rhinosinusitis (6%). Frontal outflow stenosis (36%) and mucocele (9%) were the most frequent complications observed. Improvement of overall symptoms and patient satisfaction after the OPF procedure were recorded.
Even in the endoscopic era, OPF still represents a paramount procedure that should be included in the rhino-surgeon's armamentarium, in particular in patients with challenging pathologies and anatomy when previous endoscopic endonasal attempts have failed.
回顾 5 家三级护理大学医院在使用骨成形瓣（OPF）进行额窦修复手术方面的经验。
对 2000 年至 2022 年期间因良性和炎症性病变接受过 1 次或多次内镜手术的患者进行 OPF 额窦手术的回顾性描述性分析。临床病历用于评估人口统计学、适应证、临床表现、先前的额窦手术、OPF 技术和结果。
在接受 OPF 手术的 124 名患者中，有 33 名符合纳入标准。在 2.1 次内镜手术之前，Draf III 是最常见的手术。在 30 例（91%）患者中，OPF 是联合手术的一部分。最常见的适应证是内翻性乳头状瘤（61%）、黏液囊肿（9%）和慢性鼻-鼻窦炎（6%）。最常见的并发症是额窦流出道狭窄（36%）和黏液囊肿（9%）。术后记录了患者的总体症状和满意度改善情况。
即使在鼻内镜时代，OPF 仍然是一种主要的手术方式，应成为鼻外科医生手术工具的一部分，尤其是在具有挑战性的病变和解剖结构的患者中，这些患者先前的内镜经鼻尝试已经失败。
