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Hydroxyapatite CementII. Obliteration and Reconstruction of the Cat Frontal Sinus
Craig D. Friedman, MD;
Peter D. Costantino, MD;
Kent Jones, MD;
Lawrence C. Chow, PhD;
Harold J. Pelzer, DDS, MD;
George A. Sisson, Sr, MD
Arch Otolaryngol Head Neck Surg. 1991;117(4):385-389.
Abstract
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• Frontal sinus obliteration and reconstruction can be performed with autogenous grafts or synthetic implants, each of which has significant limitations. Hydroxyapatite cement, which can be shaped intraoperatively and sets to a microporous hydroxyapatite implant, was applied to this problem. Nine cats had the anterior table of their frontal sinus unilaterally removed and the sinus cavity stripped of its mucosa. Hydroxyapatite cement was used to obliterate the cavity and reconstruct the overlying anterior table defect. The unoperated side served as the control, and the animals were sacrificed up to 18 months postoperatively. There were no adverse reactions, infections, mucoceles, or implant extrusions.
The normal anatomic contour of the forehead region overlying the hydroxyapatite cement implants was maintained in all animals. Histologic examination of undecalcified whole sinus sections revealed progressive replacement of the implants with woven bone without a loss of volume. Replacement of the hydroxyapatite cement by woven bone is postulated to occur through a combination of implant resorption coupled with osteoconduction. The use of hydroxyapatite cement proved successful for the reconstruction and obliteration of cat frontal sinuses, and may be appropriate for the same application in humans.
(Arch Otolaryngol Head Neck Surg. 1991; 117:385-389)
Author Affiliations
From the Section of Otolaryngology—Head and Neck Surgery, Yale University Medical School, New Haven, Conn (Dr Friedman); Department of Otolaryngology—Head and Neck Surgery, Northwestern University Medical School, Chicago, Ill (Drs Costantino, Jones, Pelzer, and Sisson); and the American Dental Association Health Foundation, the Paffenbarger Research Institute at the National Institute of Standards and Technology, Gaithersburg, Md (Dr Chow).
Footnotes
Accepted for publication November 2, 1990.
Presented at the Fifth International Symposium on Facial Plastic Reconstructive Surgery of the Head and Neck, June 27, 1989, Toronto, Ontario.
Reprint requests to Section of Otolaryngology—Head and Neck Surgery, Yale University School of Medicine, PO Box 3333, 333 Cedar St, New Haven, CT 06510 (Dr Friedman).
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