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Lothrop Procedure

Modified Endoscopic Lothrop Procedure

Draf III Procedure

1. Local infiltration at the axilla of the middle nasal turbinate. 2. Local infiltration at the planned septal window also.
3. Incision at the superior projection of the middle concha. 4. Removing the mucosa of the frontal process of the maxilla.
5. Opening the agger nasi. 6. Locating the ostium of the right frontal sinus.
7. Incision for the dissection of the mucosa at the septal window in the right nasal cavity. 8. Elevating and removing the septal mucosa.
9. View from the right nasal cavity after the removal of the septal mucosa. 10. Left nasal cavity. Removal of the mucosa of the frontal process of the maxilla.
11. Removal of the anterior wall of the agger nasi. 12. Locating the ostium of the left frontal sinus. A T1 frontal cell is seen.
13. View after further enlargement of the ostium of the frontal sinus. 14. Removal of the mucosa from the septal window in the left nasal cavity.
15. View from the right nasal cavity after the opening of the septal window. The axilla of the left middle nasal turbinate is seen. 16. Further enlargement of the window.
17. Thinning the frontal process of the maxilla until the exposure of the skin. 18. Continuing drilling of the left frontal process.
19. Right nasal cavity. Drilling the bone of the maxilla until the exposure of the skin. 20. Enlargement of the axilla of the middle nasal turbinate.
21. Locating the ostium of the right frontal sinus. An intersinus frontal cell is seen. 22. Left cavity. Frontal sinus. View with a 45 endoscope.
23. Left cavity. Change to angled burr. Removal of the nasal beak anteriorly and laterally. 24. As the bone of the frontal process of the maxilla is removed, the view to the frontal sinus is enlarged.
25. View from the right nasal cavity. 26. Commencing the removal of the nasal beak on the right side.
27. Removing the floor of both frontal sinuses. 28. Closer view. The suction tube lies within the intersinus frontal cell of the right frontal sinus.
29. The right frontal sinus in detail. The intersinus cell is seen, and the frontal sinus laterally. 30. The intersinus septum.
31. Removal of the intersinus septum. 32. View after removal of the intersinus septum.
33. Location of the most anterior olfactory neuron on the right side. 34. Location of the most anterior olfactory neuron on the left side also.
35. Posterior enhancement of the stoma by lowering the frontal T.