| Background and objective : Surgical treatment for chronic frontal sinusitis has underwent a long process of exploring. Frontal sinus surgery was first performed in 1750, during the two hundred years of time, many surgical methods emerged, But the ideal surgical approach has not yet been recognized. For chronic rhinosinusitis (CRS) patients, functional endoscopic sinus surgery ( FESS) is widely recognized as the classic surgical treatment of CRS. Ballon Sinuplasty, as a technical innovation which was recommended by many scholars and doctors., has some obvious advantages: maximum preservation of the normal sinus structure, less invasive, less mucosal damage, rapid recovery. However, the high cost of operations, appears to be its shortcomings. Given the current high cost of balloon dilation, it's difficult to be promoted in grass-roots hospitals, We use Foley catheter balloon in treating chronic frontal sinus, so as to explore the efficacy and feasibility of therapy.Methods: 28 patients with chronic sinusitis (all contain frontal sinusitis). All the patients hospitalized in our department received frontal sinus balloon sinuplasty and FESS surgery and regular follow-up after surgery (follow-up> 3 months) during August 2009 to June 2010 . The patients were classified by Haikou standard stage, 1type one in 12 cases, 6 cases of 1 type 2, I-3, 3, II type 1 in 3 cases, II type 2 in 4 cases. Non of them had a history of sinus surgery. 15 cases of chronic frontal sinusitis (12 cases of unilateral, 3 cases of bilateral ), only 31 frontal sinus ostia were managed with balloon sinuplasty. Specimens of the mucosa of the frontal sinus ostia were taken during operation and 1 month, 3 months after operation. Symptoms and frontal sinus ostia situation were evaluated 1 month and 3 months after operation. 20 patients with nasal septum deviation which without a history of sinusitis,were used as the control patients, Mucosa specimens of uncinate process were taken during surgeries on the nasal septum ; All specimens were observed by microscopy, and were IL-2, TNF-a immunohistochemistry stained.Results: 1. changes in patients symptoms: symptoms disappear in15 cases of chronic frontal 3months after sinus balloon sinuplasty. 2. 31 side of the frontal sinus of 28 patients show good recovery 3 months after balloon sinuplasty . 3. 31 side of the frontal sinus ostia in 28 patients with chronic sinusitis were measured by endoscopy 1 month and 3 months after balloon sinuplasty: 29 side of the frontal sinus opens well, 2 cases n a little arrow, no case of atresia. 4. light microscope: frontal sinus mucosa in 21 sides (67.7%) were squamous columnar junction epithelium 1 month after balloon sinuplasty, 10 sides (32.3%) were pseudostratified ciliated columnar epithelium; 31 sides of the frontal sinus mucosa returned to pseudostratified columnar ciliated epithelium 3 months after sinus balloon sinuplasty 5. immunohistochemical staining results: Frontal sinus balloon sinuplasty operation group, 1 month group, IL-2, TNF-a positive cells was significantly higher than the control group, P <0.01, there was significant statistical difference; frontal sinus balloon sinuplasty after 3 months, IL-2, TNF-a positive cells compared with healthy control group, P> 0.05, not significant; sinus balloon dilation in group ,1 month after operation group and 3 months after operation group, P <0.05, statistically significant. Conclusion: 1. Foley catheter balloon treatment for chronic frontal sinus ostia is effective, feasible, could be promoted in primary hospitals. 2. postoperative follow-up is very important, should be last for more than 3 months or more. Timely application of corticosteroids after operation is important for the prevention of recurrence.
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