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Modified Technique for Frontal Sinus Obliteration Using Calvarial Bone and Tisseel Glue

Kang, Gavin Chun-Wui MBBS, MRCSEd, MMed(Surg); Sng, Karen Wei-Ee MBChB, MRCSEd, MMed(Surg), FAMS(Plast Surg); Tay, Andrew George MBBS, FRCS(Edin), FAMS(Plast Surg)

Journal of Craniofacial Surgery: March 2009 - Volume 20 - Issue 2 - p 528-531
doi: 10.1097/SCS.0b013e31819b9fa1
Technical Strategies

Background: Frontal sinus obliteration is indicated in trauma and frontal sinus disease. We present our experience with a modified technique of frontal sinus obliteration.

Methods: We reviewed the records of 17 patients who underwent frontal sinus obliteration with a combination of Tisseel fibrin glue (Baxter Healthcare Corporation, Deerfield, IL) and calvarial bone and describe our technique.

Results: One female and 16 male patients (mean age, 36.6) underwent frontal sinus obliteration from 2001 to 2005. Traumatic fracture was the most common indication. The patients were followed up for a median of 15 months. There were no major complications. Postoperatively, one patient developed a localized frontal wound infection at 3 weeks; this resolved with debridement. At latest follow-up, all were free from local sinus complications, disease recurrence, headaches, or intracranial events.

Conclusions: The combined use of autogenous calvarial bone and Tisseel is suitable for frontal sinus obliteration. Our technique is associated with low donor site morbidity, avoids a separate donor surgical site, and has a low complication rate.

From the Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore City, Singapore.

Received October 3, 2008.

Accepted for publication November 26, 2008.

Address correspondence and reprint requests to Karen Wei-Ee Sng, MBChB, MRCSEd, MMed(Surg), FAMS(Plast Surg), Department of Plastic,Reconstructive and Aesthetic Surgery, Singapore General Hospital, Outram Road, Singapore City 169608, Singapore;

The authors declare that they have no relevant financial interests in this manuscript. The authors certify that they have declared their affiliations with or financial involvement with any commercial organization with direct financial interest in the subject or materials discussed in this manuscript.

© 2009 Mutaz B. Habal, MD