Endoscopic frontal sinus drillout for recurrent barotrauma: a procedure to save a pilot's career.

Abstract

Complete sphenoethmoidectomy with a Draf IIA frontal dissection is the standard of care surgical management for medically resistant diffuse recurrent sinus barotrauma. Surgical failures still occur with this technique mainly due to the propensity of the frontal outflow tract to stenose. Endoscopic frontal revisions are notoriously prone to failure and historically represented the only option for aircrew afflicted by this career-ending complication of surgery. The frontal sinus drillout or endoscopic modified Lothrop procedure (EMLP) offers a highly successful salvage surgery for postoperative frontal ostium stenosis and is particularly suited to the physiologic requirements of the aviator.