The use of the fronto-ethmosphenoid operation has been limited by me to cases of severity sufficient to balance its known imperfections. All the ethmoid lateral extensions can be obliterated by this technic. However, one must recognize that the frontal sinus is included in the operation. The responsibility for the proper attention to that cavity is at once assumed by the operator. Adequate drainage is essential. This has been the weak point in the method because, owing to the lack of bony support, the soft parts tend to be drawn toward the medial side and to block the frontonasal opening. If the frontal sinus heals before this blocking takes place or if a sufficiently large opening remains, all is well. The retention of disease in the frontal sinus without adequate drainage into the nose must lead ultimately to the formation of an abscess. This imperfection has long been recognized. It brought
SEWALL EC. EXTERNAL FRONTO-ETHMOSPHENOID OPERATION: NEW MUCOSAL FLAP FOR CONTROLLING FRONTONASAL DRAINAGE AND GRANULATION TISSUE; REVIEW OF SPHENOID TECHNIC. Arch Otolaryngol. 1934;20(1):57–60. doi:10.1001/archotol.1934.03600010064005
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