The use of cancellous bone for frontal sinus obliteration and reconstruction of frontal bony defects.

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.