[Obliteration of the frontal sinus with lyophilized cartilage in frontal fractures]

Obliteration of the frontal sinus is frequently necessary in the appropriate treatment of major craniofacial trauma of the upper third of the face. Successful frontal sinus obliteration requires (1) meticulous removal of the frontal sinus mucosa, (2) permanent occlusion of the nasofrontal duct and (3) obliteration of the denuded cavity. The current techniques include implantation of autologous fat, bone or muscle. These techniques are effective when the appropriate guidelines are respected, but the problems of donor site morbidity, which has been as high as 5%, recipient site morbidity due to the shrinkage of the free graft, and the increase in the operative time must be pointed out. The unique characteristics of lyophilized cartilage, i.e. the low resorption rate and tendency to undergo osseous substitution, justify its use for obliteration of the frontal sinus. The present study reviews 51 patients with obliteration of the frontal sinus due to craniofacial trauma. In none of the patients were there clinical or radiological signs of postoperative mucocele formation. Progressive ossification of the implanted cartilage was verified in most of the patient population.