From the Guidelines
Complications of Lynch Howarth incisions include scarring, injury to the supraorbital nerve, frontal mucocele formation, numbness, and double vision, with the most significant concern being frontal mucocele formation due to the potential for occlusion of the nasofrontal duct, as highlighted in a 2022 study published in the Journal of the American College of Radiology 1. The Lynch Howarth incision is a surgical approach used to access the frontal sinus, typically for treating frontal sinusitis or removing tumors.
- Scarring is an inevitable consequence of any surgical incision, though it may be minimized with proper technique.
- Injury to the supraorbital nerve can occur during dissection, resulting in numbness or paresthesia in the forehead region, as the nerve is located in close proximity to the surgical site.
- Frontal mucocele formation is a long-term complication that may develop if the frontal sinus drainage pathway becomes obstructed after surgery, which can occur if the nasofrontal duct is damaged during the procedure, as noted in the study 1.
- Numbness in the forehead area is specifically related to supraorbital or supratrochlear nerve damage during the procedure.
- Double vision (diplopia) can result from injury to the trochlea or superior oblique muscle, affecting eye movement, although this is a less common complication compared to others. Surgeons performing this procedure should take precautions to identify and preserve these important neurovascular structures to minimize these complications, particularly the risk of frontal mucocele formation, which can have significant long-term consequences for patients, as discussed in the context of facial trauma imaging 1. Patients should be informed of these potential risks during the consent process before undergoing the procedure, with a focus on the most critical complications, such as frontal mucocele formation, to ensure they are fully aware of the potential outcomes.
From the Research
Complications of Lynch-Howarth Incisions
The complications associated with Lynch-Howarth incisions include:
- Scarring: The use of a fenestrated Silastic drainage tube and careful positioning of the scar can help to minimize scarring 2
- Injury to supra-orbital: The supraorbital notch is a potential landmark to localize the lateral extent of the frontal sinus, and avoiding this area can help to reduce the risk of injury 3
- Frontal mucocele: The development of a frontal mucocele is a potential complication of Lynch-Howarth incisions, and can be caused by obstruction of the sinus outlet 4
- Numbness: There is no direct evidence in the provided studies to suggest that numbness is a common complication of Lynch-Howarth incisions
- Double vision: There is no direct evidence in the provided studies to suggest that double vision is a common complication of Lynch-Howarth incisions
Minimizing Complications
To minimize the risk of complications, surgeons can use techniques such as: