A Refinement of the External Frontoethmosphenoid Operation: A New Nasofrontal Pedicle Flap

When an external operation for the treatment of suppuration of the frontal sinus fails it is usually for one of two reasons. Either the opening into the nose becomes inadequate or disease is left in supraorbital ethmoid extensions with continuance of symptoms. In 1898 Lothrop1reported a study of the surgical anatomy of the frontal sinuses. Almost everything that has since been written on the subject can be found in this paper. He pointed out that the full extent of the nasal portion of the floor of the frontal sinus is not used because of thick bone anteriorly and medially. In 19142he read a paper describing an operation he had used with satisfactory results in many cases. The method, reported more fully later,3provided a large opening into the nose by removing the interfrontal septum, all the nasal portion of the floor of both