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Lothrop Procedure
Modified Endoscopic Lothrop Procedure
Draf III Procedure
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| 1. Local infiltration at the axilla of the middle nasal turbinate. | 2. Local infiltration at the planned septal window also. |
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| 3. Incision at the superior projection of the middle concha. | 4. Removing the mucosa of the frontal process of the maxilla. |
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| 5. Opening the agger nasi. | 6. Locating the ostium of the right frontal sinus. |
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| 7. Incision for the dissection of the mucosa at the septal window in the right nasal cavity. | 8. Elevating and removing the septal mucosa. |
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| 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. |
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| 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. |
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| 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. |
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| 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. |
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| 17. Thinning the frontal process of the maxilla until the exposure of the skin. | 18. Continuing drilling of the left frontal process. |
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| 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. |
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| 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. |
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| 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. |
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| 25. View from the right nasal cavity. | 26. Commencing the removal of the nasal beak on the right side. |
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| 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. |
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| 29. The right frontal sinus in detail. The intersinus cell is seen, and the frontal sinus laterally. | 30. The intersinus septum. |
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| 31. Removal of the intersinus septum. | 32. View after removal of the intersinus septum. |
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| 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. |
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| 35. Posterior enhancement of the stoma by lowering the frontal “T”. |
