Frontal Sinus Surgery Classifications

Practice vocabulary flashcards covering the Draf and International classifications for the extent of frontal sinus surgery (EFSS).

EFSS

Extent of frontal sinus surgery.

Draf $1$

Ethmoidectomy and removal of cells below the frontal sinus.

Draf $2a$

Enlargement of the frontal ostium between the lamina papyracea ($LP$) and the middle turbinate ($MT$).

Draf $2b$

Enlargement of the frontal ostium from the $LP$ and the nasal septum.

Draf $3$

Bilateral enlargement of the frontal ostia, resection of the superior nasal septum, floor of the frontal sinus and inter-sinus septum.

International classification $0$

No bone or tissue removal. Balloon dilatation.

International classification $1$

Removal of cells in the frontal recess not directly obstructing the frontal ostium.

International classification $2$

Removal of cells obstructing the ostium but not extending through the ostium.

International classification $3$

Removal of cells extending through the frontal ostium (no widening of the frontal ostium).

International classification $4$

Removal of cells extending through the frontal ostium with enlargement of the ostium (bone removal, usually frontal beak).

International classification $5$

Enlargement of the frontal ostium from the $LP$ to the nasal septum.

International classification $6$

Bilateral enlargement of the frontal ostia into a common ostium, with resection of the superior nasal septum, inter-sinus septum and floor of the frontal sinus.

$$LP$$

Lamina papyracea.

$$MT$$

Middle turbinate.

Balloon dilatation

A technique categorized under International classification $0$ involving no tissue or bone removal.

Frontal beak

The specific bone structure usually removed during International classification $4$. solos

Common ostium

The result of bilateral enlargement of the frontal ostia in International classification $6$.

Frontal recess

The anatomical location where cells are removed in International classification $1$.

Inter-sinus septum

A structure resected during Draf $3$ and International classification $6$ procedures.

Superior nasal septum

Structure resected as part of Draf $3$ or International classification $6$ for bilateral enlargement.

Floor of the frontal sinus

Anatomical floor resected in Draf $3$ or International classification $6$ to create a common ostium.

Ethmoidectomy

A procedure combined with the removal of cells below the frontal sinus in Draf $1$.

Class $1$ removal

Removal of cells in the frontal recess that do not directly obstruct the frontal ostium.

Class $3$ extension

Removal of cells extending through the frontal ostium without any widening of the ostium itself.

Class $5$ enlargement

Enlargement of the frontal ostium extending specifically from the $LP$ to the nasal septum.