Evaluation of Hydroxyapatite Cement for Frontal Sinus Obliteration After Mucocele Resection

Abstract

To retrospectively evaluate our experience with frontal sinus obliteration using hydroxyapatite cement (BoneSource; Stryker Biotech Europe, Montreux, Switzerland) and compare it with fat obliteration over the approximate same period. Frontal sinus obliteration with hydroxyapatite cement represents a new technique for obliteration of the frontal sinus after mucocele resection. Methods: Exploration of the frontal sinus was performed using bicoronal, osteoplastic flaps, with mucosal removal and duct obliteration with tissue glue and muscle or fascia. Flaps were elevated over the periorbita, and Silastic sheeting was used to protect the Bone-Source material from exposure as it dried. The frontal table was replaced when appropriate. Results: Sixteen patients underwent frontal sinus obliteration with fat (fat obliteration group), and 38 patients underwent obliteration with BoneSource (BoneSource group). Fat obliteration failed in 2 patients, who underwent subsequent BoneSource obliteration, and none of the patients in the BoneSource group has required removal of material because of recurrent complications. Frontobasal

Frontal Sinus Obliteration with Iliac Crest Bone Grafts. Review of 8 Cases

“…When used without reconstruction of the anterior table with bone or titanium mesh they may lead to long-term defects of contour. 1,17,19,22,23,[26][27][28][29]34,36 Autologous fat and cancellous bone are frequently used to obliterate the frontal sinus when treating frontal sinus fractures. Successful obliteration requires meticulous extirpation of the sinus mucosa and obliteration of the drainage system.…”

“…Those materials have presented varying degrees of success for frontal sinus obliteration. [27][28][29][30][31][32][33][34][35][36][37][38] This article reviews patients who sustained frontal sinus fractures treated by obliteration of the sinus with autogenous cancellous bone.…”

Obliteración del seno frontal para el tratamiento de fístulas de LCR y meningoencefaloceles

“…Las complicaciones del sitio de la extracción son mínimas y autolimitadas 12 y no suelen generar problemas estéticos a nivel frontal. Como alternativa a la grasa se pueden usar cementos artificiales, como la hidroxiapatita o apatita carbonatada [14][15][16] . Estos materiales presentan la ventaja de no disminuir de volumen 4,15 y de evitar la morbilidad del sitio de extracción.…”

“…Estos materiales presentan la ventaja de no disminuir de volumen 4,15 y de evitar la morbilidad del sitio de extracción. El riesgo de infección es variable, oscilando entre 5% y 13% [14][15][16] , y puede ser necesaria la reintervención para retirar el material y tratar la infección 16 . Además, conlleva un importante mayor coste.…”

Utility of the pericranial flap in frontal sinus and anterior cranial fossa trauma

“…Proponents of these materials state their utility in patients who have lost bone from the anterior table due to expanding mucoceles, infections leading to osteomyelitits or severe comminution due to trauma. Hydroxyapatite cement has been used to reconstruct the contour of the frontal bone in such cases 15,20 . In these situations, another option would be to reconstruct the missing bone with split calvarial graft and obliterate the sinus space with the pericranial flap as described in this article.…”