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The use of cancellous bone for frontal sinus obliteration and reconstruction of frontal bony defects
1Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Medical Center, Ohio.
Objective:
The objective of this report is to review our experience and indications for the use of cancellous bone in frontal sinus obliteration and reconstruction of frontal defects. We also describe a method of minimizing iliac crest donor-site morbidity.
Design:
Case series.
Setting:
Patients treated on the Facial Plastics and Trauma Service at the University of Cincinnati (Ohio) Medical Center.
Patients:
Ten patients were selected for frontal sinus obliteration and reconstruction of frontal defects with cancellous bone based on the following criteria: (1) complex frontal bony defects involving the frontal sinus; (2) acute trauma with loss or comminution of more than 40% of either anterior or posterior sinus wall; and (3) failure of previous frontal sinus obliteration for either chronic sinusitis or trauma.
Intervention:
The use of cancellous bone grafts for frontal sinus obliteration and reconstruction of frontal defects.
Main Outcome Measure:
Success of cancellous bone grafts in frontal sinus obliteration and reconstruction of frontal defects.
Results:
Follow-up averaged 26 months. Follow-up computed tomographic scans showed good maintenance of graft volume and complete frontal sinus obliteration in all patients. Seven of 10 patients reported minimal donor-site discomfort and three patients had moderate pain.
Conclusion:
Cancellous bone grafts are effective, with acceptable donor-site morbidity, for frontal sinus obliteration and frontal reconstruction in patients in whom adipose grafts would have a significant chance of complications or long-term failure.
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