KeypointsExposed drilled bone in Draf IIb and III procedures promotes restenosis by inducing osteitis and neo‐osteogenesis.This reaction can be avoided by covering bone with local mucoperiosteal flaps that optimise the healing processIn a series of 16 patients, a septoturbinal flap (STF) and lateral‐based nasoseptal flap (LNSF) are harvested to cover the posterior and anterior edge of the frontal cavity, respectively.These flaps do not overlap and can be harvested from the same side.Clinical feasibility of double mucoperiosteal flaps in Draf IIb and III was demonstrated with promising results in terms of frontal cavity restenosis prevention (93.75% success rate). A favourable healing process was noted with minimal crusting during the postoperative period.INTRODUCTIONThe frontal sinus is the most challenging of all paranasal sinuses despite major advances in endoscopic approaches, instrumentations and image guidance systems. Draf IIb and III procedures include extensive bone drilling with resection of the mucosa. Leaving exposed drilled bone is a major factor that contributes to postoperative failure because it induces osteitis with subsequent neo‐osteogenesis, scarring and ostium restenosis. Covering the posteriorly exposed bone with a single local mucoperiosteal flap was recently proposed to overcome this issue with promising results. Vascularised flaps are rapidly integrated to the bony surface
Clinical Otolaryngology – Wiley
Published: Jan 1, 2018
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