Transpalpebral approach for frontal sinus diseases: a camouflaged technique

Abstract

Endoscopic or transfacial external frontal sinus approaches do not provide good monitoring of the frontal sinus lateral extent. Moreover, endoscopic or transfacial external approaches remain associated with numerous complications or therapeutic failure, e.g. frontal sinus drainage pathway synechia, healing problems or residual hypoesthesia.

We propose a rapid, easy-to-perform, 5-step procedure called the transpalpebral approach which is indicated in case of sequestered disease within the lateral extent of the frontal sinus. We use this technique in the following indications (osteomas, mucoceles, inverted papillomas, fungus balls, foreign bodies).

Our transpalpebral approach avoids leaving a visible scar and entails no danger to the skull base, the frontal sinus drainage pathway or the supratrochlear and supraorbital pedicles. It provides wide access to the lateral extent of the frontal sinus and also reduces the number of transfacial external approaches required.

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