Study of nasofrontal beak identification as a useful landmark in endoscopic frontal sinus surgery

Abstract

Background: The nasal process of the frontal bone creates a bony thickening in the midline known as the nasofrontal beak (NFB). Surgery on the frontal sinuses can be safer when the NFB is used as a marker. Objective: To assess if identification of the nasofrontal beak during endoscopic frontal sinus surgery will add benefit to the identification of fontal sinus drainage pathway. Patients and Methods: From July 2020 to July 2021, At Zagazig University Hospitals, Otorhinolaryngology Department; trial included twelve patients with chronic frontal sinusitis who had been refractory to medical treatment for at least twelve weeks. All patients were scheduled for functional endoscopic sinus surgery. Results: The mean of distance from superior border of nasal beak to skull base in the right (Rt) side was 4.8 ± 2.9 and in the left (Lt) side was 5.4 ± 3.1. In terms of difficulty and distance, there was a significant negative association between the two variables; meaning that increasing distance would make the surgery easier. No recurrence of symptoms in Rt. side while in Lt. side recurrence occurs in only one case. Restenosis of frontal ostium didn’t occur in any case in Rt side or Lt side. No nasal adhesions in Rt side, but occurred in Lt side in only one case Conclusion: The frontonasal beak is one of these fixed anatomical bony landmarks as frontal sinus ostium is located at the anterior edge of the anterior recess. Preoperative imaging can anticipate the difficulties of frontal recess surgery by identifying it.