Abstract
Since Wormald et al. proposed the ‘building block concept,’ many studies have suggested that frontal sinus surgery should be performed following Wormald’s procedure. However, in Japan, little is known about the ability of otolaryngologists to perform frontal sinus surgery. In addition, new procedures in transnasal endoscopic surgery have been suggested in recent years, including a Draf type III endoscopic modified Lothrop procedure (EMLP) and endoscopic medial maxillectomy/endoscopic modified medial maxillectomy (EMM/EMMM). However, the prevalence of use of these new procedures is not clear. Therefore, we sent questionnaires on endoscopic maxillary and frontal sinus surgeries to otorhinolaryngologists who were associated with Osaka University. The results showed that in endoscopic sinus surgery (ESS), an operation on the frontal sinus was still considered to be the most difficult. Only 8% of doctors were able to perform endoscopic modified Lothrop procedure, and the most common reason why a hospital did not use endoscopic modified Lothrop procedure was that ‘no doctors can perform endoscopic modified Lothrop procedure.’ endoscopic medial maxillectomy/endoscopic modified medial maxillectomy was more commonly performed compared to endoscopic modified Lothrop procedure. For both endoscopic modified Lothrop procedure and endoscopic medial maxillectomy/endoscopic modified medial maxillectomy, doctors who could not perform these procedures stated that ‘I want to learn these procedures, but no there are no doctors who can teach them.’ This suggests that management of training for endoscopic modified Lothrop procedure and endoscopic medial maxillectomy/endoscopic modified medial maxillectomy is important.
