Frontal sinus obliteration by a composite multifractured osteoperiosteal flap: a pilot study

The objective result is to obliterate the frontal sinus by a neo-osteogenic tissue, which develops behind the composite multifractured osteoperiosteal flap (CMOF) tailored from the anterior wall's bone cortex of the frontal sinus in the New Zealand rabbit model. In this study, as surgical objects 4 New Zealand rabbits were used. First, in each animal, the CMOF was formed from the anterior wall's bone cortex of the frontal sinus. After obtaining the CMOF, the remainder of the cortical bone of the anterior wall was removed by a drill. This procedure provided an anteriorly opened frontal sinus cavity, which has been filled firstly with absorbable gelatin sponge and finally covered with the CMOF. To investigate any possible neo-osteogenic activity behind the CMOF, CT scans of the paranasal sinuses were obtained on the first day and on the third month after surgery. Besides those, to histologically verify the developments, biopsies were obtained from behind the flap at the end of the third month. Evaluation of the CT images of the paranasal sinuses, confirms that more than half of the volume has been filled in frontal sinuses. Likewise, histologically, clear evidence of osteoblastic activity has been detected in each biopsy material. In this rabbit model, we have shown that more than half of the frontal sinus' cavity can be filled by the neo-osteogenic tissue forming behind the CMOF.