The Sewall-Boyden flap reconstruction of the surgically created frontonasal tract
created during a classic Lynch frontoethmoidectomy is a procedure that philosophically
is in keeping with modern concepts of sinus and mucosa preservation that are the hallmarks
of successful modern endoscopic sinus surgery. Although the procedure is now mostly
of historical interest, the basis of the “frontal sinus rescue” operation and basic
tenets of frontal sinus surgery owe some of their intellectual development to this
mucosal flap–based tract reconstruction technique. This article provides a step by
step description with detailed drawings of the technique to provide a basis for study
of the procedure. Although occasionally used adjunctively today for narrow indications,
the Sewall-Boyden technique has been largely replaced by endoscopic transnasal surgery
procedures such as the Endoscopic Lothrop and the Draf 3.
Keywords
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