[Use of tissue adhesives in the reconstruction of the frontal sinus]

Fractures of the anterior wall of the frontal sinus, complicated by impression of bone fragments, can cause serious functional and cosmetic disturbances. Surgeons often remove those fragments and obliterate the sinus. But disfigurement from the operation will be worse than that caused by original lesion and can only be corrected by further plastic surgery. Some surgeons use the technique of joining bone fragments by metal or thread sutures but it is only possible when the fragment are not too small. We present four patients treated over a period of 1975-1979 with the reconstruction of the frontal sinus from its fragments using cyanoacrylic tissue adhesive (Chirurcoll-Polfa). One patient was operated immediately after an accident, two patients one month after a trauma and another after six months. The adhesive tissue was applied in single drops directly on the edges of dry surface of bone fragments. The fragments can be joined only in some points because the tissue adhesive can not make an isolation layer between them. The tissue adhesive speeds up the processes of ossification. We observed no interference with wound healing, no detrimental effect of this method in the postoperative course and no pathologic local and general reactions. The adhesive tissue makes manipulation in the operative field easier. The functional and esthetic results were satisfactory and further corrective surgery was not necessary.