{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T18:43:02Z","timestamp":1760985782044,"version":"3.37.3"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,12,12]],"date-time":"2018-12-12T00:00:00Z","timestamp":1544572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Previous studies have demonstrated a high failure rate of endoscopic sinus surgery (ESS) with Draf IIa in patients with diffuse polyposis, asthma, and aspirin\u2010exacerbated respiratory disease. A high percentage of these patients progress to endoscopic modified Lothrop procedure (EMLP). We describe a modification of the Draf IIb with a superior septectomy (IIb+SS), which may provide similar therapeutic benefit as demonstrated by the distribution of sinus irrigations in the sinus cavity with ESS with IIb+SS vs ESS with EMLP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>ESS with IIb+SS was performed on 6 cadaver heads. Fluorescein\u2010dyed irrigations were performed on each head and penetration was recorded using video endoscopy. EMLP was subsequently performed on each head with repeat dye\u2010irrigation and video endoscopy. The videos were reviewed by 4 blinded fellowship\u2010trained rhinologists, and irrigant penetration of the maxillary, ethmoid, frontal, sphenoid sinuses, and olfactory cleft was graded 0 to 3 (3 implying complete staining).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean scores when comparing IIb+SS to EMLP were as follows: overall 1.99 vs 1.97 (<jats:italic>p<\/jats:italic> = 0.816), maxillary sinus 2.67 vs 2.38 (<jats:italic>p<\/jats:italic> = 0.128), ethmoid sinus 1.88 vs 1.98 (<jats:italic>p<\/jats:italic> = 0.536), sphenoid sinus 2.58 vs 2.50 (<jats:italic>p<\/jats:italic> = 0.467), frontal sinus 1.13 vs 1.38 (<jats:italic>p<\/jats:italic> = 0.073), and olfactory cleft 1.71 vs 1.63 (<jats:italic>p<\/jats:italic> = 0.529). There was no significant difference between subsites. Interrater reliability was good (Cronbach's alpha = 0.781).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Performing ESS with IIb+SS provides similar irrigation delivery benefits to ESS with EMLP, without the need for altering natural sinus outflow and creating circumferential scarring. Further studies evaluating its use in patients that are high risk for revision surgery are needed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.22228","type":"journal-article","created":{"date-parts":[[2018,12,12]],"date-time":"2018-12-12T12:13:44Z","timestamp":1544616824000},"page":"281-285","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Draf IIB with superior septectomy: finding the \u201cmiddle ground\u201d"],"prefix":"10.1002","volume":"9","author":[{"given":"Vidur","family":"Bhalla","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Kansas Medical Center  Kansas City KS"},{"name":"Saint Luke's Hospital of Kansas City  Kansas City MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin J.","family":"Sykes","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Kansas Medical Center  Kansas City KS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5645-4210","authenticated-orcid":false,"given":"Jennifer A.","family":"Villwock","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Kansas Medical Center  Kansas City KS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. David","family":"Beahm","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Kansas Medical Center  Kansas City KS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanley W.","family":"McClurg","sequence":"additional","affiliation":[{"name":"Saint Luke's Hospital of Kansas City  Kansas City MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander G.","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Kansas Medical Center  Kansas City KS"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,12,12]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21065"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21366"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348941112000304"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21015"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.2500\/105065800779954266"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000176542.59985.9f"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21109"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21715"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23610"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000425"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21686"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21894"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26741"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20653"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006680"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000147922.12228.1f"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26248"},{"key":"e_1_2_6_20_1","first-page":"7","article-title":"Outcome analysis of endoscopic sinus surgery for chronic sinusitis in patients having Samter's triad","volume":"29","author":"Amar YG","year":"2000","journal-title":"J Otolaryngol"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21739"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23671"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26391"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22032"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24213"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.125.1.92"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25947"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/00034894061150S903"}],"container-title":["International Forum of Allergy &amp; Rhinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alr.22228","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/alr.22228","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alr.22228","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T08:44:19Z","timestamp":1694681059000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/alr.22228"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,12]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1002\/alr.22228"],"URL":"https:\/\/doi.org\/10.1002\/alr.22228","archive":["Portico"],"relation":{},"ISSN":["2042-6976","2042-6984"],"issn-type":[{"type":"print","value":"2042-6976"},{"type":"electronic","value":"2042-6984"}],"subject":[],"published":{"date-parts":[[2018,12,12]]},"assertion":[{"value":"2018-02-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}