[Growth stimulus of the paranasal sinuses with tissue expanders]

Various congenital craniofacial deformities show hypoplastic paranasal sinus. The Treacher Collins, the Apert and Crouzon Syndromes and the Hemicraniofacial Microsomy, among others, are typical examples of this observation. Stimuli to the growth of the paranasal sinus during the facial growth period could sensibly improve the treatment of deformity, or even avoid later surgeries. Since their introduction in plastic surgery, tissue expanders are progressively acquiring greater importance in many areas of the specialty. This is a safe and simple alternative to solve difficult cases. It has been demonstrated that real tissue growth occurred in all layers of cutaneous tissues subjected to expansion, including the induction of mitoses. Recent works showed that microorbits could be corrected through the introduction of expanders in their orbits. The authors proposed that to stimulate the growth of paranasal sinus, tissue expanders should be introduced bilaterally in the maxillar, frontal, ethmoidal and sphenoidal sinus, which should promote the development of the face. The expansion induced should be controlled and gradual through injections of small amounts of saline in each session. This project includes the cautious design of the size and shape of the expanders as well as the care with adequate draining of the sinusal cavity and the possible mechanical atrophy of the mucosal lining of the sinus.