{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:02:19Z","timestamp":1791810139926,"version":"4.3.4"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,9,24]],"date-time":"2019-09-24T00:00:00Z","timestamp":1569283200000},"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":[[2019,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The endoscopic modified Lothrop procedure (EMLP) is used to manage ongoing refractory frontal sinusitis after failed previous endoscopic sinus surgery (ESS), but this approach has a significant restenosis rate. We evaluated the potential benefits of mucosal grafts and pedicled flaps on the opening of the newly formed frontal ostium.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty patients with refractory frontal sinusitis or mucoceles after ESS were randomized to undergo EMLP, either with (n = 27) or without (n = 23) mucosal grafts and pedicled flap reconstruction of the neo\u2010ostium. The frontal neo\u2010ostium was measured with Lindholm distending forceps, and anteroposterior (A\u2010P) and lateral dimensions were measured intraoperatively, and then again at 6 weeks, 6 months, and 12 months postoperatively. Olfaction outcomes were assessed using the Taiwan Smell Identification Test (TWSIT) and a smell visual analog scale (VAS) score preoperatively and at 6 months postsurgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The initial intraoperative mean lateral and A\u2010P dimensions were 23.2 \u00b1 2.7 mm and 14.8 \u00b1 2.3 mm and were significantly decreased at all time\u2010points postoperatively. The mucosal grafts and pedicled flaps had greater lateral and A\u2010P dimensions, and a greater percentage of intraoperative frontal neo\u2010ostium area at all time\u2010points postoperatively (all <jats:italic>p<\/jats:italic> &lt; 0.05). At 6 months postoperatively, TWSIT (<jats:italic>p<\/jats:italic> = 0.027), but not the smell VAS score (<jats:italic>p<\/jats:italic> = 0.063), was significantly improved compared with baseline. TWSIT and smell VAS score changes did not differ between groups (<jats:italic>p<\/jats:italic> = 0.92 and <jats:italic>p<\/jats:italic> = 0.85, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of mucosal grafts and pedicled flaps reduces stenosis of the frontal neo\u2010ostium postsurgery and should be considered after EMLP.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.22416","type":"journal-article","created":{"date-parts":[[2019,9,24]],"date-time":"2019-09-24T15:17:35Z","timestamp":1569338255000},"page":"1387-1394","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Free mucosal grafts and anterior pedicled flaps to prevent ostium restenosis after endoscopic modified Lothrop (frontal drillout) procedure: a randomized, controlled study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0756-2853","authenticated-orcid":false,"given":"Ying\u2010Piao","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2012Head and Neck Surgery Mackay Memorial Hospital  Taipei Taiwan"},{"name":"Department of Audiology and Speech Language Pathology Mackay Medical College  New Taipei City Taiwan"},{"name":"School of Medicine Mackay Medical College  New Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping\u2010Hung","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Kuang\u2010Tien General Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010Chun","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2012Head and Neck Surgery Mackay Memorial Hospital  Taipei Taiwan"},{"name":"Department of Audiology and Speech Language Pathology Mackay Medical College  New Taipei City Taiwan"},{"name":"School of Medicine Mackay Medical College  New Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter\u2010John","family":"Wormald","sequence":"additional","affiliation":[{"name":"Department of Surgery\u2012Otolaryngology Head and Neck Surgery University of Adelaide  Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,9,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1043-1810(10)80087-9"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-59989570080-3"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21738"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200006000-00028"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e31806865be"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22055"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811432423"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21708"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22122"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2012.26.3731"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200302000-00015"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2015.29.4174"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200101000-00024"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200107000-00030"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/194589240201600206"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2010.24.3518"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-6665(05)70300-5"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2013.01.019"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20565"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.2500\/105065898780182444"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21715"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26794"}],"container-title":["International Forum of Allergy &amp; 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