Endoscopic frontal sinus drillout for recurrent barotrauma: A procedure to save a pilot's career

Erik K. Weitzel, Jay T. Flottmann, K. Chris McMains

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Introduction: Complete sphenoethmoidectomy with a Draf IIA frontal dissection is the standard of care surgical management for medically resistant diffuse recurrent sinus barotrauma. Surgical failures still occur with this technique mainly due to the propensity of the frontal outflow tract to stenose. Endoscopic frontal revisions are notoriously prone to failure and historically represented the only option for aircrew afflicted by this career-ending complication of surgery. The frontal sinus drillout or endoscopic modified Lothrop procedure (EMLP) offers a highly successful salvage surgery for postoperative frontal ostium stenosis and is particularly suited to the physiologic requirements of the aviator. Case: A high-performance aircraft pilot developed frontal stenosis after extensive sinus surgery for recurrent sinus barotrauma. Multiple failed endoscopic attempts to rehabilitate his sinuses finally gave way to success using the EMLP. He was returned permanently to flight duty at 6 wk post-op. Discussion: This case report represents the first published successful application of the modified endoscopic Lothrop procedure to a pilot with recurrent frontal sinus barotrauma.

Original languageEnglish (US)
Pages (from-to)660-662
Number of pages3
JournalAviation Space and Environmental Medicine
Issue number7
StatePublished - Jul 2009
Externally publishedYes


  • Draf III
  • Endoscopic modified lothrop procedure
  • Endoscopic sinus surgery
  • Frontal drillout
  • Recurrent sinus barotrauma

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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