The method for the provision of a frontal duct for adequate ventilation and drainage is the weakest point in the surgical technic of the complete external operation on the fronto-ethmosphenoid sinuses.
I prefer covering the exposed periorbita and cut edge of the nasal process of the maxilla with epithelium as the simplest and most certain means of accomplishing this.
I have advocated1 applying this graft over a rubber tube inserted into the frontal sinus. The small surface of periorbita tangent to the largest tube which can be safely inserted does not furnish a sufficiently broad surface for growth in a small percentage of cases. The contraction of the graft into a cord during the process of healing defeats it purpose.
Fig. 1.—Inflatable rubber pad.
Fig. 2.—The pad in use.
A larger surface must be covered with epithelium. This is readily accomplished by utilizing the inflatable rubber pad
SMITH F. ADDITIONS TO THE COMPLETE OPERATION ON THE FRONTO-ETHMOSPHENOID SINUSES. Arch Otolaryngol. 1935;22(2):184–185. doi:10.1001/archotol.1935.00640030197007
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