Case Report: Bilateral Frontal Sinus Abscess and Mucopyocele Drainage using “Modified” Draf III

Abstract Draf III is a surgical technique which uses endoscopic approach to access the frontal sinus, by leaving almost no skin markings and having minimal side-effects. The aim of the technique is to drain frontal sinus masses and collections. In this report we present a 16-year-old male with progressive headaches, dizziness, nausea and vomiting; whose imaging revealed left-predominant bilateral frontal sinus mucocele and abscess. An endoscopic intranasal Draf III approach was used to drain the abscess along with mucosal grafting to avoid crusting and stenosis. Additionally, two bilateral supraorbital incisions (beneath the eyebrows) were made for better access and drainage of the mucocele. The patient was then started on antibiotics and steroids and was followed-up in three sessions to evaluate healing and complications. On the third-month follow-up the patient was doing well and had no complaints. Draf III with slight modifications can be a decent endoscopic approach in managing bilateral frontal sinus abscess and mucopyocele in treatment-resistant cases, without causing any major complications