Analysis of Therapeutic Efficacy of Endoscopic Transethmoidal Ethmoidectomy Combined With Endoscopic Transnasal Frontal Sinusotomy in the Treatment of Refractory Frontal Sinusitis

OBJECTIVE: To evaluate the clinical efficacy of a combined approach involving transfrontal sinus debridement and transnasal endoscopic frontal sinusotomy in the treatment of postcraniotomy frontal sinusitis. METHODS: A retrospective study was conducted on a cohort of 20 patients with postcraniotomy frontal sinusitis treated by the endoscopic surgery team at the Department of Neurosurgery, The First Affiliated Hospital of China Medical University, over a 5-year period. All patients underwent the combined procedure of transfrontal sinus debridement and transnasal endoscopic frontal sinusotomy, followed by the placement of a drug-eluting biodegradable stent within the widened frontal sinus ostium. Postoperative management included daily saline nasal irrigation and regular outpatient endoscopic debridement of nasal crusts to maintain frontal sinus drainage. Patients were followed up for a minimum of 6 months, with only 1 case of recurrence (recurrence rate, 5%). This combined approach leverages the advantages of neurosurgical transfrontal sinus debridement and otolaryngological transnasal endoscopic frontal sinusotomy, augmented by strict postoperative nasal irrigation and regular outpatient nasal cleaning, thereby significantly reducing the recurrence rate. CONCLUSION: The combined approach of transfrontal sinus debridement and transnasal endoscopic frontal sinusotomy effectively mitigates the high recurrence rate of postcraniotomy frontal sinusitis.