栫博幸, 青山敬, 喜多村健ほか：副鼻腔嚢胞手術の臨床統計. 耳鼻咽喉科臨床 1992;59:43-52.
E W Fisher, H B Whittet, C B Croft
Symptomatic mucosal cysts of the maxillary sinus: antroscopic treatment.
J Laryngol Otol. 1989 Dec;103(12):1184-6.
Abstract/Text
Antroscopy has been shown to have a role in the diagnosis and treatment of antral disease. Four cases of 'non-secreting' benign antral cysts, each presenting with facial pain, were successfully treated using antroscopic techniques. The aetiology and management of these lesions is reviewed with the recommendation that antroscopic removal is the treatment of choice for all symptomatic cases, and for asymptomatic cases in which the diagnosis is in doubt.
柳 清, 今井 透, 飯村慈朗ほか：上顎洞に発生する粘膜嚢胞（Mucosal cyst）に対するMinimum invasive surgery -Fenestration法によるShaver systemの使用. 耳展, 2001; 44:34-39.
澤田弘毅, 柳 清, 桜井 裕ほか：頭痛を伴う蝶形骨洞粘膜嚢胞（Retention cyst）の3症例. 耳展, 2005; 48: 174-181.
竹内裕一, 生駒尚秋, 竹内裕美：前頭洞・篩骨洞・蝶形骨洞嚢胞性疾患の検討. 耳鼻と臨床 1997;43(Suppl.3):754-759.
P Eloy, S Vlaminck, M Jorissen, P Hellings, M Timmermans, J Daele, P Ransky, S Hassid, T Van Zele, C Bachert, A L Poirrier, B Bertrand
Type III frontal sinusotomy: surgical technique, indications, outcomes, a multi-university retrospective study of 120 cases.
B-ENT. 2011;7 Suppl 17:3-13.
Abstract/Text
Draf in 1991. The procedure--which is also known as the modified endoscopic Lothrop procedure--aims to create the largest possible anteroposterior and lateral to lateral opening between both frontal sinuses and the nasal cavities. This requires the resection of the medial floor of both frontal sinuses, the intersinus septum and the superior nasal septum. The authors present a retrospective study including a cohort of 120 patients who underwent surgery in six Belgian university ENT departments. Mean follow-up was 24.6 months (range: 5-36 months). This paper describes the surgical procedure and reviews the indications, comorbidities, outcomes and complications of the type III frontal sinusotomy. Some correlations are also established with the data published in the worldwide literature. The authors conclude that the Draf III is a demanding procedure requiring considerable expertise in endoscopic sinus surgery. The procedure is effective with a success rate of 87.5%. Indeed, 12.5% of patients only experienced closure of the neoostium while 20% of all the patients had unchanged or worse symptomatology. The percentage of post-operative complications is 7.5%. All complications were managed successfully.
秋月裕則, 近藤英司, 大山晴三ほか：多房性鼻腔嚢胞の術前MRIの有用性. 耳鼻咽喉科臨床 2008;101(3):195-200.
秋月裕則, 近藤英司, 大山晴三ほか：多胞性副鼻腔嚢胞の術前MRIの有用性. 耳鼻咽喉科臨床, 2008;101(3): 195-200.
金川英寿, 菅原一真, 綿貫浩一ほか：異なる嚢胞成分が検出された多発性・多房性術後性上顎嚢胞の1例. 耳鼻咽喉科・頭頸部外科, 2008;80(11):785-787.
C F Lanzieri, M Shah, D Krauss, P Lavertu
Use of gadolinium-enhanced MR imaging for differentiating mucoceles from neoplasms in the paranasal sinuses.
Radiology. 1991 Feb;178(2):425-8. doi: 10.1148/radiology.178.2.1987603.
Abstract/Text
The purpose of this study was to determine whether additional clinically useful information could be obtained from gadolinium-enhanced magnetic resonance (MR) imaging compared with the information obtained from nonenhanced MR imaging and computed tomography (CT). Therefore, the authors selected 41 patients, whose results at CT examinations demonstrated a variety of pathologic conditions of the paranasal sinuses, to undergo MR imaging both with and without the use of gadopentetate dimeglumine for contrast enhancement. In 22 of 35 cases of neoplasms and mucoceles occurring separately, the lesions were correctly differentiated by established MR signal criteria alone. However, 32 of these 35 cases were accurately differentiated when gadolinium-enhanced MR images were obtained. Six cases demonstrated co-existing neoplasm and mucocele: Gadolinium-enhanced MR enabled correct differentiation of five of these lesions, while unenhanced MR enabled correct differentiation of three. On the basis of these results, the authors conclude that the use of gadopentetate dimeglumine for contrast enhancement at MR imaging is useful for differentiating mucoceles from neoplasms in the sinonasal tract.
A Ruelle, R Pisani, G Andrioli
"Unusual" MRI appearance of sphenoid sinus mucocele.
Neuroradiology. 1991;33(4):352-3.
Abstract/Text
The authors report a case of sphenoid sinus mucocele which exhibited unusual MRI features. However a review of the literature shows that these lesions may present with different MRI appearances probably related to the variability of the cyst content. Further series are needed for a better definition of the MRI behaviour of the lesions.
宇田川友克, 柳 清, 石井彩子ほか：多房性術後性上顎嚢胞に対する内視鏡下鼻内手術（ESS）の適応と限界．耳展, 2005; 48: 160-166.
柳清, 鴻信義, 深見雅也ほか：術後性上顎洞嚢胞に対する内視鏡下鼻内手術．耳鼻咽喉科展望, 1992;35：425-433.
飯塚雄志, 深見雅也, 柳清ほか：術後性上顎洞嚢胞に対する内視鏡下鼻内手術．耳鼻と臨床, 1996;89:587-592.
Tsuguhisa Nakayama, Daiya Asaka, Tetsushi Okushi, Mamoru Yoshikawa, Hiroshi Moriyama, Nobuyoshi Otori
Endoscopic medial maxillectomy with preservation of inferior turbinate and nasolacrimal duct.
Am J Rhinol Allergy. 2012 Sep-Oct;26(5):405-8. doi: 10.2500/ajra.2012.26.3791.
Abstract/Text
BACKGROUND: Endoscopic medial maxillectomy (EMM) is a safe and effective procedure for treatment of inverted papilloma (IP) originating from the maxillary sinus. However, EMM usually removes the inferior turbinate and nasolacrimal duct. The inferior turbinate has a critical function in conditioning of the nasal airflow, and resection of the nasolacrimal ducts has a risk of epiphora. We developed a newly derived surgical technique, endoscopic modified medial maxillectomy (EMMM), which enables preservation of the inferior turbinate and nasolacrimal duct.
METHODS: A retrospective case series of six patients with IP and nine patients with mucoceles of the maxillary sinus after a Caldwell-Luc operation, who underwent surgery using the EMMM technique, were reviewed.
RESULTS: In patients with IP, there were no recurrences for a mean follow-up of 16.7 months. Eight of nine patients with mucoceles of the maxillary sinus showed patency. All patients showed preservation of the inferior turbinate. One patient with mucocele was referred for dacryocystorhinostomy because of epiphora.
CONCLUSION: EMMM produces access to the maxillary sinus identically to conventional EMM, despite preservation of the inferior turbinate and nasolacrimal duct.
Kazuhiro Omura, Kazuhiro Nomura, Satoshi Aoki, Nobuyoshi Otori, Yasuhiro Tanaka
Direct approach to the anterior and lateral part of the maxillary sinus with an endoscope.
Auris Nasus Larynx. 2019 Dec;46(6):871-875. doi: 10.1016/j.anl.2019.03.006. Epub 2019 Apr 4.
Abstract/Text
OBJECTIVE: The Caldwell-Luc (CL) approach with a sublabial incision is used to manipulate the anterior wall of the maxillary sinus. Paresthesia is one of the major complications associated with the CL approach. We developed a new method, "direct approach to the anterior and lateral part of the maxillary sinus with an endoscope" (DALMA), that negates the need for a sublabial incision and minimizes dental paresthesia by reducing the risk of anterior superior alveolar nerve injury. This study aimed to describe how to perform the DALMA technique, and to review its effectiveness and associated complications.
METHODS: We retrospectively reviewed 10 patients who had received DALMA.
RESULTS: Ten patients underwent DALMA. The anterior superior alveolar nerve was identified in all patients. Access to the lateral side beyond the infraorbital canal and anterior wall of the maxillary sinus was achieved.
CONCLUSIONS: DALMA is a simple, effective, and minimally invasive technique that can be used as an alternative to CL with sublabial incision.
Copyright © 2019 Elsevier B.V. All rights reserved.
柳 清：嚢胞性疾患. 耳鼻咽喉科外来シリーズ1 鼻・副鼻腔外来, メジカルビュー社, 1999;186-195.
C Georgalas, F Hansen, W J M Videler, W J Fokkens
Long terms results of Draf type III (modified endoscopic Lothrop) frontal sinus drainage procedure in 122 patients: a single centre experience.
Rhinology. 2011 Jun;49(2):195-201. doi: 10.4193/Rhino10.153.
Abstract/Text
OBJECTIVES: To assess the effectiveness and factors associated with restenosis after Draf type III (Endoscopic Modified Lothrop) frontal sinus drainage procedure.
DESIGN: Retrospective analysis of prospectively collected data.
PATIENTS: A hundred and twenty two consecutive patients undergoing Draf III procedure for recalcitrant chronic frontal rhinosinusitis (CRS) (71%), frontal sinus mucocoele (15%), benign frontal sinus tumours (9%) and cystic fibrosis with severe CRS (5%) were followed up for an average of 33 months.
OUTCOME MEASURES: Symptom burden (Visual Analogue Scale and Rhinosinusitis Outcome Measure), patency of neo-ostium and revision surgery.
RESULTS: At the end of follow up, ninety percent of patients had a patent neo-ostium, while 88% were either clinically better or completely asymptomatic. Thirty-nine patients required endoscopic revision surgery and 9 eventually underwent frontal sinus obliteration. Sixty percent of revision operations were performed during the first two years. RSOM showed a significant improvement in both general and nasal symptoms while on a VAS, headache improved significantly. The only factor weakly associated with re-stenosis was the presence of allergy. There were no major complications during any of the procedures.
CONCLUSION: Draf III Procedure is safe and effective for patients who have failed conventional frontal sinus procedures and a valid alternative to frontal sinus obliteration. Although the revision rate may appear to be quite significant, it can often be performed as an outpatient procedure and needs to be balanced against the reduced morbidity and the ease of follow-up.
月舘利治, 柳清, 飯田誠ほか:前頭洞嚢胞に対する手術法の検討とその予後 ―嚢胞交通路の開存率を中心に―. 耳鼻咽喉科展望, 1998; 41:609-614.
月舘利治, 柳清, 飯田誠ほか: 前頭洞嚢胞について. JOHNS, 1998;14：117-122.
瀬野悟史, 桜井弘徳, 花満雅一, 清水猛史：ステント留置を行った前頭洞嚢胞症例の検討(原著論文). 日本鼻科学会会誌,2006;45(4):390-393.
海江田哲, 高野篤, 畑地憲輔ほか：難治性前頭洞嚢胞に対する充填術の検討(原著論文/症例報告). 日本鼻科学会会誌, 2004; 43(2) :206-211.
Peter Anderson, Raj Sindwani
Safety and efficacy of the endoscopic modified Lothrop procedure: a systematic review and meta-analysis.
Laryngoscope. 2009 Sep;119(9):1828-33. doi: 10.1002/lary.20565.
Abstract/Text
OBJECTIVES/HYPOTHESIS: The endoscopic modified Lothrop procedure (EMLP; also known as Draf III or frontal drillout) has recently gained popularity as a minimally invasive alternative to frontal sinus obliteration. This systematic analysis was designed to assess the safety and efficacy of the EMLP.
STUDY DESIGN: Literature review and meta-analysis.
METHODS: We performed a search of all English studies published from 1990 to 2008 that reported results from a minimum of five patients undergoing the EMLP. Of the 33 papers reviewed, 18 studies (evidence level II-2 or II-3) containing data from 612 patients met inclusion criteria.
RESULTS: The most common indications for EMLP were chronic frontal sinusitis (75.2%) and mucocele (21.3%). Patients had an average age of 47.9 years (range, 14-89 years) and were followed for 28.5 months postoperatively. Only 20.3% of procedures were performed without image-guidance. Stents were rarely used (6%). The rate of major and minor complications was <1% and 4%, respectively. No deaths were reported. A majority of patients were discharged within 24 hours. Postoperative endoscopic findings, qualitatively reported in 394 patients, demonstrated frontal sinus patency or partial stenosis in 95.9% at last follow-up. Where specifically assessed (n = 430 patients), improvement in symptoms was achieved in 82.2% of cases, with 16% reporting no significant change, and 1.2% reporting worsening of symptoms. The overall failure rate (requiring further surgery) of EMLP was 13.9% (85/612). Of the failures, 80% underwent revision EMLP, whereas 20% elected osteoplastic frontal sinus obliteration.
CONCLUSIONS: When performed by an experienced surgeon, EMLP is a safe and efficacious procedure that is well tolerated.
森山寛, 中島庸也, 島田士郎ほか: 視力障害を伴う術後性の後部副鼻腔嚢胞例の検討. 耳鼻咽喉科展望, 1988;31：803-811.
森山寛, 島田和哉, 斎藤健ほか: 後部副鼻腔嚢腫. 耳鼻咽喉科展望, 1981;24:465-480.
Shinya Morita, Kenji Mizoguchi, Keiji Iizuka
Paranasal sinus mucoceles with visual disturbance.
Auris Nasus Larynx. 2010 Dec;37(6):708-12. doi: 10.1016/j.anl.2010.04.002. Epub 2010 Jun 8.
Abstract/Text
OBJECTIVE: Paranasal sinus mucoceles may cause visual disturbance in patients because of their close proximity to the orbit. We aimed to investigate visual prognosis to determine whether it is influenced by the interval before surgery and the severity of visual disturbance, and to heighten the physician's awareness of the occurrence of this disease.
METHODS: We retrospectively reviewed eight surgically treated patients with paranasal sinus mucoceles accompanied by visual disturbances between March 2005 and January 2009, and examined the visual acuity outcome of the patients.
RESULTS: Four patients with a mild visual acuity loss showed improvement after surgical drainage within 1 month after onset. Two patients with visual disturbances persisting for more than 1 year did not show postoperative improvements. Although two patient's preoperative visual acuity loss was worse than the ability to count fingers, they showed a remarkable improvement after surgery.
CONCLUSIONS: These results show the importance of diagnosing and treating paranasal sinus mucoceles with visual disturbance as soon as possible. In addition, the improvement of visual acuity can be expected if surgery is performed within 1 month after onset, and the patient's preoperative visual acuity loss is mild. However, if patients with severe visual acuity loss consult otolaryngologists at a later date, surgery may still be considered worthwhile.
Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.
飯沼壽孝, 大澤博之, 広田佳治ほか: 蝶形骨洞嚢胞の臨床的研究. 日耳鼻, 1985;88:719-727.
T Yokoyama, S Inoue, J Imamura, T Nagamitsu, Y Jimi, S Katoh, H Kameda, S Abiko
Sphenoethmoidal mucoceles with intracranial extension--three case reports.
Neurol Med Chir (Tokyo). 1996 Nov;36(11):822-8.
Abstract/Text
Three unusual cases of sphenoethmoidal mucoceles with rare intracranial extension are reported. A 64-year-old female presented with a 7-month history of right visual disturbance. Computed tomography (CT) and magnetic resonance (MR) imaging demonstrated a huge mass in the right middle fossa. She underwent right frontotemporal craniotomy. Postoperatively, her proptosis and cranial nerve dysfunction had improved markedly. A 53-year-old female complained of headache, nausea, and dizziness. CT and MR imaging revealed a cystic mass filling the right sphenoid sinus. The cystic lesion was evacuated through the transnasal approach. She was doing well postoperatively and has been asymptomatic. A 39-year-old male complained of headache, vomiting, and right visual disturbance. CT and MR imaging demonstrated a homogeneous mass occupying the sphenoid sinus. Sphenoidotomy exposed the cyst extending superiorly into the anterior cranial fossa. He recovered from the visual disturbances and has been asymptomatic since. MR imaging provides confirmation of the diagnosis of sphenoethmoidal mucocele and is important for preoperative evaluation.
春名眞一：副鼻腔嚢胞性疾患 内視鏡手術(解説), 頭頸部外科, 2008;18(2): 115-117.
森山寛, 春名真一, 関博之ほか：術後性の前頭,篩骨,蝶形骨洞嚢胞について. 耳鼻咽喉科展望, 1991;34(3): 299-306.
出島健司、石坂成康、宮崎 信: 術後性上顎洞嚢胞に対するESS. JOHNS, 2000;16:73-77.
飯村慈朗, 平林秀樹, 春名眞一：当科におけるナビゲーションシステムを用いた内視鏡下鼻内副鼻腔手術. 耳鼻咽喉科展望, 2008; 51(5): 326-329.
鴻信義, 春名眞一, 森山寛ほか：ナビゲーションシステムを利用した内視鏡下鼻内副鼻腔嚢胞開放術. 耳鼻咽喉科展望, 1999;42(3) : 283-288.
鴻信義, 和田弘太, 吉川衛ほか：術後性上顎嚢胞に対するナビゲーション手術. 耳鼻咽喉科展望, 2006;49(5): 318-321.
和田弘太, マルシオ中西, 鴻信義ほか：前頭洞嚢胞に対するナビゲーションサージャリー(原著論文). 耳鼻咽喉科展望, 2002;45(5):355-361.
鴻信義, 吉川衛, 春名眞一ほか：ナビゲーションシステムを利用した内視鏡下鼻内手術(原著論文). 日本耳鼻咽喉科学会会報, 2000;103(1)1-6.
