Frontal ostium neo-osteogenesis and patency after Draf III procedure: a computer-assisted study.

BACKGROUND: Stenosis of the frontal neo-ostium after Draf III procedure has been associated with inflammatory risk factors. However, the degree to which neo-osteogenesis contributes to postsurgical stenosis of the frontal neo-ostium is unclear.

METHODS: Twenty-five patients with chronic frontal sinusitis who underwent Draf III procedure and had been followed for at least 12 months were included. Paranasal sinus computed tomography (CT) scans were performed 7 days and 1 year postoperatively. The frontal neo-ostium cross-sectional area and the amount of frontal neo-osteogenesis were measured by a standardized protocol using triplanar radiologic viewing software. Association between the severity of frontal neo-osteogenesis and the patency of the neo-ostium was analyzed, as was the correlation between the extent of neo-osteogenesis and the preoperative Global Osteitis Scoring Scale (GOSS), Lund-Mackay score (LMS), Lund-Kennedy score (LKS), serum eosinophil count, and history of previous surgery.

RESULTS: At 1 year postoperatively, significant inverse correlation was found between the size of the frontal neo-ostium and the extent of neo-osteogenesis. According to a multiple linear regression model, the severity of neo-osteogenesis was positively correlated with preoperative GOSS and negatively correlated with asthma (p < 0.05). Additionally, there was no association between extent of neo-osteogenesis and the preoperative LMS, LKS, serum eosinophil count, and history of previous surgery.

CONCLUSION: Neo-osteogenesis has a significant impact on the patency of the frontal neo-ostium but appears unrelated to inflammatory factors. Patients with a higher risk for developing neo-osteogenesis can be identified preoperatively based on GOSS; these patients may benefit from closer monitoring during the follow-up period.