Modified mini-lothrop/extended draf IIB procedure for contralateral frontal sinus disease: A case series

Jean Anderson Eloy, Mark E. Friedel, Arjuna B. Kuperan, Satish Govindaraj, Adam J. Folbe, James K. Liu

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Background: Management of frontal sinus disease represents one of the most challenging aspects of endoscopic sinus surgery. In select cases, anatomic variations (outflow tract osteoneogenesis, scarring, fat prolapsed from previous orbital decompression) may hinder ipsilateral access using traditional endoscopic approaches. We previously proposed a modification of the standard Draf IIB procedure which incorporates a frontal intersinus septectomy (modified mini-Lothrop procedure/extended Draf IIB) to access and manage recalcitrant unilateral frontal sinus obstruction inaccessible ipsilaterally in cadaver specimens. In this study, we describe this technique, and present a case series of 4 patients who benefited from this approach. Methods: A retrospective analysis at a large tertiary referral center was performed on all patients undergoing frontal sinus surgery between July 2008 and June 2011. Four patients with frontal sinus recess obstruction inaccessible from the ipsilateral side and treated with the modified mini-Lothrop procedure/extended Draf IIB were identified. Results: All 4 patients underwent successful frontal sinusotomies via a Modified mini-Lothrop procedure/extended Draf IIB without complications and had a patent drainage pathway assessed endoscopically after a mean follow-up of 21 (range, 9-28) months. Conclusion: The modified mini-Lothrop procedure/extended Draf IIB represents a feasible approach and adequate alternative to more traditional endoscopic and open frontal sinus procedures in select cases. This modification was successful in addressing difficult to access unilateral frontal sinus disease in this small cohort. © 2012 ARS-AAOA, LLC.

Original languageEnglish (US)
Pages (from-to)321-324
Number of pages4
JournalInternational Forum of Allergy and Rhinology
Issue number4
StatePublished - Jul 2012

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Otorhinolaryngology


  • Case series
  • Endoscopic modified Lothrop procedure
  • Endoscopic sinus surgery
  • Extended Draf IIB
  • Frontal intersinus septectomy
  • Frontal sinus disease
  • Frontal sinus surgery
  • Lothrop procedure
  • Mini-Lothrop


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