The Draf III procedure (modified Lothrop procedure, endoscopic frontal drillout) is performed for which primary indication?

• A Isolated frontal mucocele with intracranial extension
• B First-time frontal sinusitis with septal deviation
• C Pediatric frontal sinusitis not responding to antibiotics
• D Recurrent frontal sinusitis after failed Draf IIb with very narrow frontal recess ✓

Explanation

The Draf III (modified Lothrop) creates a large common frontal neo-ostium by removing the frontal intersinus septum, superior nasal septum, and floor of both frontal sinuses endoscopically. It is the most extensive endoscopic frontal approach, reserved for recalcitrant frontal sinusitis after failed previous endoscopic procedures (Draf IIb) or for revision FESS where frontal recess anatomy is very narrow due to scarring. It is not indicated as a first-line approach. Isolated mucocele with intracranial extension may need external approach.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.