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.