From the Research
The most common complication of Lynch Howarth incisions is frontal mucocele (option c). Lynch Howarth incisions are external approaches used for accessing the frontal sinus during procedures like frontal sinusotomy. When performing this procedure, the disruption of the normal drainage pathway of the frontal sinus can lead to obstruction and subsequent development of a mucocele. A frontal mucocele occurs when mucus secretions become trapped within the sinus cavity due to blockage of the frontal recess or nasofrontal duct, causing gradual expansion of the sinus. This complication may develop months to years after surgery and presents with symptoms like frontal headache, orbital displacement, or swelling. While scarring (option a), injury to the supraorbital nerve (option b), and numbness (option d) can occur following Lynch Howarth incisions, they are less common than mucocele formation, as seen in a case report where a patient underwent a transethmoidal approach using the Howarth-Lynch medial incision without surgical complications 1. Management of frontal mucoceles typically requires surgical drainage and establishment of a patent drainage pathway, often through endoscopic approaches in modern practice, as demonstrated in a case where a subperiosteal orbital abscess was drained using a combined endoscopic and external approach, via a Lynch-Howarth incision 2. Some key points to consider when evaluating the potential complications of Lynch Howarth incisions include:
- The risk of mucocele formation due to disruption of the frontal sinus drainage pathway
- The potential for scarring, injury to the supraorbital nerve, and numbness, although these are less common
- The importance of proper surgical technique and postoperative care to minimize the risk of complications
- The role of endoscopic approaches in the management of frontal mucoceles and other complications related to Lynch Howarth incisions.