Value of septoturbinal flap in the frontal sinus drill-out type IIb according to draf.

Objectives/hypothesis: The Draf IIb aims at widening the frontal sinus drainage in a minimally invasive fashion. However, this technique is associated with a high stenosis rate. Hence, local nasal flaps have been recently introduced or designed to speed up mucosal healing and prevent scarring.
Study Design: The objective of this study was to present the septoturbinal flap (STF), its use in a Draf IIb, and to examine postoperative outcomes of this procedure.
Methods: From an initial pool of 48 patients with frontal sinus disease to be treated with a Draf IIb, we prospectively selected 46 (95.84%) patients, submitted to a Draf IIb with STF in two Institutions, from November 2010 to November 2014. We excluded two cases (4.16%) for which a flap could not be performed for anatomic restrictions. We present the STF technique and describe demographic data, indication for surgery, and surgery type.
Results: Indications for surgery included 24 (52.17%) mucoceles or mucopyoceles, 12 (26.1%) chronic rhinosinusitis, four (8.7%) osteomas, two (4.35%) meningoencephaloceles, and four (8.7%) inverted papillomas. Difficult anatomic conditions were encountered in half of the patients. Restenosis of the frontal sinus drainage pathway occurred in one (2.17%) patient. Far-seated frontal mucoceles recurred in two cases (4.35%), with frontal drainage pathway remaining patent. Rescue treatment comprised a Draf III in two cases and one frontal sinus obliteration. Outcome was favorable for 43 (93.5%) patients.
Conclusion: The use of STF was associated with a high rate of success for a Draf IIb.
Level of Evidence: 4. Laryngoscope, 126:2428-2432, 2016.
(© 2016 The American Laryngological, Rhinological and Otological Society, Inc.)