Anterior Table Free Bone Graft Technique for Frontal Sinus Obliteration

1992 ◽  
Vol 106 (4) ◽  
pp. 363-366 ◽  
Author(s):  
Roy R. Casiano ◽  
Jonathan Cooper
Keyword(s):  
Bone Resorption ◽  
Bone Graft ◽  
Frontal Sinus ◽  
Bone Flap ◽  
Frontal Sinusitis ◽  
Review Of The Literature ◽  
Cosmetic Results ◽  
Flap Technique ◽  
Sinus Obliteration ◽  
Neurovascular Structures

The osteoplastic flap technique for exposure of the frontal sinus has been an accepted approach for cases in which obliteration or exploration of the frontal sinus has been necessary. Preservation of vascularized anterior pericranium is credited with reduction of the chances of anterior table bone resorption and subsequent cosmetic deformity. Disadvantages include the need for templates and unpredictable random fracturing in the supraorbital rim area, increasing the chance of potential injury to the periorbita and/or supraorbital neurovascular structures as well as limiting surgical exposure in some cases. Ten patients with chronic frontal sinusitis underwent frontal sinus obliteration using an anterior fable free bone graft technique over a 3 year period. The superior orbital neurovascular pedicles were easily identified and protected within its pericranial sheath in all cases. All patients had precise delineation of the frontal sinus anterior bone flap margins with no need for templates. Bone graft viability was documented in all patients, along with excellent cosmetic results comparable to the osteoplastic flap technique. A review of the literature and description of the technique are presented.

Osteoplasty Flap Technique for Repair of Latent (30-Year) Post-Traumatic Frontal Sinus Mucocele: Case Report and Review of the Literature

2012 ◽  
Vol 70 (9) ◽  
pp. 2092-2096 ◽  
Author(s):  
Chan M. Park ◽  
Enrico Stoffella ◽  
Jason Gile ◽  
Jeffrey Roberts ◽  
Alan S. Herford
Keyword(s):  
Case Report ◽  
Frontal Sinus ◽  
Review Of The Literature ◽  
Flap Technique ◽  
Post Traumatic

scholarly journals Role of Osteoplastic Frontal Sinus Obliteration in the Era of Endoscopic Sinus Surgery

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Joshua B. Silverman ◽  
Stacey T. Gray ◽  
Nicolas Y. Busaba
Keyword(s):  
Frontal Sinus ◽  
Tertiary Care ◽  
Sinus Surgery ◽  
Salvage Procedure ◽  
Frontal Sinusitis ◽  
First Line ◽  
Total Study Population ◽  
Sinus Disease ◽  
History Of ◽  
Sinus Obliteration

Objective. Determining the indications for osteoplastic frontal sinus obliteration (OFSO) for the treatment of inflammatory frontal sinus disease.Study Design. Retrospective case series from a single tertiary care facility.Methods. Thirty-four patients who underwent OFSO for chronic frontal sinusitis () and frontal sinus mucocele () comprised our study group. Data reviewed included demographics, history of prior frontal sinus operation(s), imaging, diagnosis, and operative complications.Results. The age range was 19 to 76 years. Seventy percent of patients with chronic frontal sinusitis underwent OFSO as a salvage surgery after previous frontal sinus surgery failures, while 30% underwent OFSO as a primary surgery. For those in whom OFSO was a salvage procedure, the failed surgeries were endoscopic approaches to the frontal sinus (69%), Lynch procedure (12%), and OFSO outside this study period (19%). For patients with frontal sinus mucocele, 72% had OFSO as a first-line surgery. Within the total study population, 15% of patients presented for OFSO with history of prior obliteration, with a range of 3 to 30 years between representations.Conclusions. Osteoplastic frontal sinus obliteration remains a key surgical treatment for chronic inflammatory frontal sinus disease both as a salvage procedure and first-line surgical therapy.

Endoscopic Frontal Sinus Obliteration: A New Technique for the Treatment of Chronic Frontal Sinusitis

2005 ◽  
Vol 133 (4) ◽  
pp. 551-555 ◽  
Author(s):  
Feodor Ung ◽  
Raj Sindwani ◽  
Ralph Metson
Keyword(s):  
Frontal Sinus ◽  
Medical Center ◽  
Academic Medical Center ◽  
Invasive Technique ◽  
Control Group ◽  
Endoscopic Drainage ◽  
Frontal Sinusitis ◽  
Retrospective Case ◽  
Additional Surgery ◽  
Sinus Obliteration

OBJECTIVES: Patients who fail endoscopic drainage procedures for chronic frontal sinusitis often require obliteration of the frontal sinus with abdominal fat. The purpose of this study was to evaluate an endoscopic technique for frontal sinus obliteration. STUDY DESIGN AND SETTING: Retrospective case-control. Thirty-five patients underwent frontal sinus obliteration using either an endoscopic (n = 10) or conventional osteoplastic flap (n = 25) technique from 1994 to 2004 at an academic medical center. RESULTS: Patients undergoing endoscopic obliteration had less blood loss (P = 0.006), decreased operative time (P = 0.016), and a shorter hospital stay (P = 0.003) compared to osteoplastic control subjects. All 3 surgical complications occurred in the control group. No patients required additional surgery for frontal sinusitis. CONCLUSIONS: The endoscopic approach to frontal sinus obliteration appears to reduce patient morbidity and should be considered in the surgical management of advanced frontal sinus disease. SIGNIFICANCE: This is the first report of a minimally-invasive technique for frontal sinus obliteration.

Frontal sinus obliteration with autologous calvarial bone graft: indications and results

2014 ◽  
Vol 271 (11) ◽  
pp. 2957-2962 ◽  
Author(s):  
Pierre Vironneau ◽  
André Coste ◽  
Virginie Prulière-Escabasse
Keyword(s):  
Bone Graft ◽  
Frontal Sinus ◽  
Calvarial Bone ◽  
Sinus Obliteration

scholarly journals Fat obliteration of the front sinus in recurrent frontal sinusitis: a clinical case

2020 ◽  
Vol 27 (2) ◽  
pp. 127-134
Author(s):  
T. V. Banashek-Meshcheriakova ◽  
F. V. Semenov ◽  
V. G. Kolomiytsev ◽  
A. Yu. Agarkova
Keyword(s):  
Adipose Tissue ◽  
Frontal Sinus ◽  
Clinical Case ◽  
Platelet Rich Plasma ◽  
Venous Blood ◽  
Frontal Sinusitis ◽  
Nasal Breathing ◽  
Good Cosmetic ◽  
The Right ◽  
Sinus Obliteration

Aim. To describe a case of fat obliteration using platelet-rich plasma in a patient with recurrent chronic frontal sinusitis.Materials and methods. A clinical case of a 60-year-old patient who had repeatedly performed extranasal frontotomy for recurrent chronic frontal sinusitis with a short-term effect is described. Due to the ineffectiveness of conservative and traditional surgical treatment, taking into account the characteristics of the clinical picture and the presence of a cosmetic defect in the area of projection of the right frontal sinus, as well as CT results (postoperative bone defect of the right half of the frontal bone), a right-side extranasal frontotomy was performed. The operation involved sinus obliteration with adipose tissue obtained from areas of the thigh anterior surface by lipoaspiration under low pressures with the addition of platelet-rich plasma (PRP) prepared by a single centrifugation of whole venous blood. An assessment of the patient’s condition and fat transplant was carried out on the basis of objective examination after 4 and 6 months and 1.5 year after the surgery and the results of control computed tomography (CT).Results. No complaints regarding nasal breathing from the frontal sinus were registered during control examinations. A good cosmetic result and the absence of pain during palpation in the right frontal sinus were observed. According to CT results, the density of the contents of the frontal sinus corresponded to that of adipose tissue; the volume of material did not changed.Conclusion. Frontal sinus obliteration with adipose tissue and PRP addition is a promising method for treating patients with recurrent chronic frontal sinusitis and repeatedly performed extranasal frontotomy. This method has several advantages over other methods.

Presence of Propionibacterium acnes in patients with aseptic bone graft resorption after cranioplasty: preliminary evidence for low-grade infection

2020 ◽  
Vol 133 (3) ◽  
pp. 912-917 ◽  
Author(s):  
Vicki M. Butenschoen ◽  
Mirja Seifert ◽  
Bernhard Meyer ◽  
Sandro M. Krieg
Keyword(s):  
Bone Resorption ◽  
Bone Graft ◽  
Propionibacterium Acnes ◽  
Bone Infection ◽  
Bone Flap ◽  
Control Group ◽  
Low Grade ◽  
Neurosurgical Department ◽  
Decompressive Hemicraniectomy ◽  
Microbial Spectrum

OBJECTIVEAutologous bone graft reimplantation remains the standard treatment after decompressive hemicraniectomy. Unfortunately, some patients present with signs of bone resorption without any visible signs of infection; the reasons remain unknown. Contamination with Propionibacterium acnes has been discussed as a potential source of the osteolytic process. The aim of this study was to investigate the microbial spectrum detected in samples of grafts from patients with aseptic bone resorption and compare them to septic bone graft infections in order to identify P. acnes as the specific pathogen of aseptic bone resorption.METHODSThe authors retrospectively reviewed all patients treated for aseptic bone resorption between 2012 and 2017 in their neurosurgical department. Septic infections were used as a control group to gain information on the present bacterial spectrum. Perioperative data such as demographics, number of surgeries, and complications were assessed and compared with the microbiological analyses conducted in order to detect differences and potential sources for aseptic bone resorption and possible differences in bacterial contamination in septic and aseptic bone infection.RESULTSIn total, 38 patients underwent surgery between 2012 and 2017 for septic bone infection—14 for aseptic bone resorption. In 100% of the septic bone infection cases in which bone flap removal was needed, bacteria could be isolated from the removed bone flap (55% Staphylococcus aureus, 13.2% Enterococcus faecalis, and 18.4% Staphylococcus epidermidis). The microbial spectrum from samples of aseptic bone flaps with resorption was examined in 10 of 14 patients and revealed contamination with P. acnes in 40% (n = 4, the other 6 bone grafts were sterile), especially in sonication analysis, whereas visible septic bone infection was mainly caused by S. aureus without detection of P. acnes.CONCLUSIONSAseptic bone resorption may be caused by low-grade infections with P. acnes. However, further analysis needs to be conducted in order to understand its clinical relevance and treatment perspective.

Endoscopic Frontal Sinus Obliteration: A New Technique for Chronic Frontal Sinusitis

2004 ◽  
Vol 131 (2) ◽  
pp. P53-P53 ◽  
Author(s):  
Feodor Ung ◽  
Raj Sindwani ◽  
Ralph B Metson
Keyword(s):  
Frontal Sinus ◽  
New Technique ◽  
Frontal Sinusitis ◽  
A New Technique ◽  
Sinus Obliteration

First results of frontal sinus obliteration with a synthetic, resorbable and osteoconductive bone graft of ß-tricalcium phosphate

2017 ◽  
Vol 131 (6) ◽  
pp. 534-540 ◽  
Author(s):  
M Andratschke ◽  
H Hagedorn
Keyword(s):  
Bone Graft ◽  
Tricalcium Phosphate ◽  
Frontal Sinus ◽  
Demographic Data ◽  
Retrospective Chart Review ◽  
Good Alternative ◽  
Bone Graft Substitute ◽  
Sinus Surgery ◽  
Symptom Improvement ◽  
Sinus Obliteration

AbstractBackground:Despite advances in endoscopic sinus surgery, frontal sinus obliteration is still indicated in some cases. Current options for obliteration include autologous and synthetic materials. The use of ß-tricalcium phosphate as a resorbable bone graft substitute is a good alternative for frontal sinus obliteration. This study aimed to report our experience with this material.Methods:A retrospective chart review of patients who underwent frontal sinus obliteration at our clinic between 2008 and 2013 was performed. Demographic data, indications, previous surgery, and immediate and late complications were examined. Information on persisting symptoms and patient outcomes was collected using a telephone questionnaire in February 2016.Results:None of the patients underwent further surgery for frontal sinus disease. All of them reported a good cosmetic result and symptom improvement.Conclusion:ß-tricalcium phosphate is a good, safe and cost-effective material for frontal sinus obliteration.

Combined Endoscopic Intranasal and External Frontal Sinusotomy

1997 ◽  
Vol 11 (5) ◽  
pp. 349-354 ◽  
Author(s):  
John P. Bent ◽  
Robert A. Spears ◽  
Frederick A. Kuhn ◽  
Scot M. Stewart
Keyword(s):  
Frontal Sinus ◽  
Effective Alternative ◽  
Frontal Sinusitis ◽  
Postoperative Results ◽  
Consecutive Sample ◽  
Major Complications ◽  
Intranasal Surgery ◽  
Sinus Obliteration ◽  
Physical Findings

We review our experience treating patients with medically refractory frontal sinusitis that could not be relieved with endoscopic intranasal surgery alone. Fourteen combined external and intranasal endoscopic frontal sinusotomies were performed on a consecutive sample of 11 patients presenting over a 38-month period of study. Postoperative results were classified as cured, improved, unchanged, or worse, based on patient symptoms and physical findings. At a mean postoperative follow-up of 19 months (range 4–36), 100% of these patients had benefited from this technique (7 cured, 4 improved, 0 unchanged, 0 worse). There were no major complications and natural sinus physiology was preserved. We conclude that a combined external and endoscopic intranasal frontal sinusotomy is an effective alternative to frontal sinus obliteration.

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