[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-45367-en":3,"doc-seo-45367-105":30,"detail-sidebar-cat-0-en-105":92},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":22,"language":23,"language_code":24,"site_id":25,"html_lang":24,"table_of_contents":26,"faqs":27,"seo_title":13,"seo_description":14,"update_tm":28,"read_time":29},45367,1099513958762,"Logic","https://ap-avatar.wpscdn.com/avatar/1000023916a998db790?x-image-process=image/resize,m_fixed,w_180,h_180&k=1782109480056885918",8,"Research & Report","Clinical features and surgical outcomes of the Draf III procedure: systematic review","Draf III is a demanding endoscopic technique that has gained popularity for treating frontal sinus pathologies. This systematic review provides a comprehensive overview of clinical indications, pre-operative evaluation, operative strategies, post-operative management, and complications, with comparative analysis between primary and revision Draf III. Outcomes also evaluate the role of mucosal flaps and stents to reduce re-stenosis risk. Primary success reaches 83.5% while revision success is 71%, with flap use showing higher neo-ostium patency than stents.","European Archives of Oto-Rhino-Laryngology [https://doi.org/10.1007/s00405-024-08957-7](https://doi.org/10.1007/s00405-024-08957-7)  \nClinical features, operative management and surgical results of first Draf III procedure, revision Draf III approach and the use of mucosal flaps and stents: a systematic review  \nFrancesco Chiari1 · Pierre Guarino2 · Claudio Donadio Caporale2 · Klizia Orsini3 · Gianluca Trevisi4,5 · Livio Presutti1 · Gabriele Molteni1,6  \nReceived: 2 July 2024 / Accepted: 27 August 2024  \n© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024  \nAbstract  \nObjectives Draf III procedure is a challenging endoscopic technique, which has gradually gained an increasing popularity in treating frontal sinus pathologies. The main aim of this systematic review is to offer a comprehensive overview on clinical indications, pre-operative evaluation, surgical techniques, post-operative management and complications of the Draf III procedure. As a step forward, such issues have been comparatively evaluated as referred to patients who underwent primary Draf III procedure and revision DRAF III one) . Finally, surgical outcomes related to mucosal flaps and stents to prevent re-stenosis are analyzed.  \nMethods A systematic literature review has been performed following PRISMA 2020 checklist statement. An automated search has been carried out by applying an extensive set of queries on the Embase/PubMed, Scopus and Cochrane databases, relating to papers published from 2000 to 2021.  \nResults Frontal chronic refractory sinusitis is the most frequent indication to Draf III procedure (72%), followed by mucoceles (11%) and skull base or paranasal tumors (10%) . The success rate of primary and revision Draf III are 83.5% and 71%, respectively. The re-stenosis phenomenon seems to depend on allergic mechanism and polyposis) . The use of mucosal flaps could improve the Draf III efficacy, better than the use of stents (87 vs 72% of neo-ostium patency) .  \nConclusion Draf III is a safe and highly effective surgical technique. However, some limited clinical conditions require some careful technical features, such as the use of mucosal flap, in order to prevent re-stenosis.  \nKeywords Draf III · Frontal sinus surgery · Frontal chronic sinusitis · Modified Lothrop procedure  \n* Pierre Guarino [pierreguarino@hotmail.com](pierreguarino@hotmail.com)  \n1 Otolaryngology and Audiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy  \n2 Otolaryngology Head and Neck Unit,“Santo Spirito”Hospital, Pescara, Italy  \n3 Neurosurgical Unit,“G. Mazzini” Hospital, Teramo, Italy  \n4 Neurosurgical Unit,“Santo Spirito” Hospital, Pescara, Italy  \n5 Department of Neurosciences, Imaging and Clinical Sciences,“G. D’Annunzio” University, Chieti, Italy  \n6 Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum di Bologna, Bologna, Italy  \nIntroduction  \nThe endoscopic approach to the frontal sinus and the frontal recess is notoriously considered the most challenging part of endoscopic sinus surgery (ESS) [1] . The frontal recess is characterized by a complicated anatomy, and specific instrumentation for surgery or even inspection is still somewhat limited., However, such a technology handicap has not prevented conventional surgery approach from gradually gaining some popularity, although per se technically demanding: a rigorous training programme is required, including ex-vivo animals as well as cadaver dissection, attending surgical courses and observing experienced surgeons in action are to be faced as enabling prerequisites to approach real life practice [1–3] .  \nIndeed, several endoscopic techniques have been proposed to perform frontal paranasal procedures. In 1991 Wolfgang  \nDraf first described a series of extended procedures to sequentially open the frontal sinus outflow tract more widely, referred to as Draf I, Draf IIa, Draf IIb and Draf III [4]. Among these, the last one is","cbCaiiX631dONgAt","https://ap.wps.com/l/cbCaiiX631dONgAt","pdf",909268,5,1,12,"English","en",105,"# Introduction\n# Material and methods\n## Search strategy and information sources\n# Results\n# Discussion\n# Conclusion","[{\"question\":\"What clinical conditions most often lead to performing the Draf III procedure?\",\"answer\":\"Frontal chronic refractory sinusitis is the most frequent indication (72%), followed by mucoceles (11%) and skull base or paranasal tumors (10%).\"},{\"question\":\"How do surgical success rates compare between primary and revision Draf III procedures?\",\"answer\":\"The success rate is 83.5% for primary Draf III and 71% for revision Draf III, with re-stenosis influenced by mechanisms such as allergy and polyposis.\"},{\"question\":\"How do mucosal flaps and stents affect neo-ostium patency and re-stenosis prevention?\",\"answer\":\"Use of mucosal flaps improves Draf III efficacy compared with stents, with neo-ostium patency reported as 87% versus 72%, helping to prevent re-stenosis.\"}]",1783458686,30,{"code":4,"msg":31,"data":32},"ok",{"site_id":25,"language":24,"slug":33,"title":13,"keywords":34,"description":14,"schema_data":35,"social_meta":87,"head_meta":89,"extra_data":91,"updated_unix":28},"clinical-features-and-surgical-outcomes-of-the-draf-iii-procedure-systematic-review","",{"@graph":36,"@context":86},[37,54,69],{"@type":38,"itemListElement":39},"BreadcrumbList",[40,44,48,51],{"item":41,"name":42,"@type":43,"position":21},"https://docshare.wps.com","Home","ListItem",{"item":45,"name":46,"@type":43,"position":47},"https://docshare.wps.com/document/","Document",2,{"item":49,"name":12,"@type":43,"position":50},"https://docshare.wps.com/document/research-report/",3,{"item":52,"name":13,"@type":43,"position":53},"https://docshare.wps.com/document/clinical-features-and-surgical-outcomes-of-the-draf-iii-procedure-systematic-review/45367/",4,{"url":52,"name":13,"@type":55,"author":56,"headline":13,"publisher":58,"fileFormat":61,"inLanguage":24,"description":14,"dateModified":62,"datePublished":63,"encodingFormat":61,"isAccessibleForFree":64,"interactionStatistic":65},"DigitalDocument",{"name":9,"@type":57},"Person",{"url":41,"name":59,"@type":60},"DocShare","Organization","application/pdf","2026-07-20","2026-07-07",true,{"@type":66,"interactionType":67,"userInteractionCount":20},"InteractionCounter",{"@type":68},"ViewAction",{"@type":70,"mainEntity":71},"FAQPage",[72,78,82],{"name":73,"@type":74,"acceptedAnswer":75},"What clinical conditions most often lead to performing the Draf III procedure?","Question",{"text":76,"@type":77},"Frontal chronic refractory sinusitis is the most frequent indication (72%), followed by mucoceles (11%) and skull base or paranasal tumors (10%).","Answer",{"name":79,"@type":74,"acceptedAnswer":80},"How do surgical success rates compare between primary and revision Draf III procedures?",{"text":81,"@type":77},"The success rate is 83.5% for primary Draf III and 71% for revision Draf III, with re-stenosis influenced by mechanisms such as allergy and polyposis.",{"name":83,"@type":74,"acceptedAnswer":84},"How do mucosal flaps and stents affect neo-ostium patency and re-stenosis prevention?",{"text":85,"@type":77},"Use of mucosal flaps improves Draf III efficacy compared with stents, with neo-ostium patency reported as 87% versus 72%, helping to prevent 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