Comparison of fast-setting calcium phosphate bone cement and fat autograft in a rabbit model of frontal sinus obliteration.
BACKGROUND
Traditionally, chronic obstruction of the frontal recess is managed by frontal sinus obliteration (FSO). This often requires the harvest of abdominal fat as a filler with all of its associated morbidity. In this study, we investigate the efficacy of calcium phosphate bone cement (Craniofacial Repair System [CRS]) as a material for FSO.


METHODS
Eighteen New Zealand white rabbits were divided into three groups and carried out to two time periods. Six rabbits underwent FSO with fat autograft (control group) and 12 rabbits underwent FSO with CRS (study groups 1 and 2, respectively). At 52 weeks, six control and six study rabbits were killed. The remaining six rabbits were killed at 78 weeks. All specimens underwent radiological evaluation with spiral computed tomography (CT) followed by gross inspection. Histological evaluation was then performed to assess bony growth and to evaluate the interface of the sinus wall with the obliterative material.


RESULTS
Sinuses obliterated with CRS showed complete obliteration radiographically. This was apparent at 52 weeks and remained static at 78 weeks. Histological analysis indicated persistent obliteration of the sinus cavity from 52 to 78 weeks and signs of osteoinduction. There were no complications observed as a result of the operative procedure or the materials used.


CONCLUSIONS
CRS is an alternative to fat autograft for FSO in this noninfected animal model. Further studies are needed to evaluate its long-term efficacy as well as its behavior in chronically infected sinuses.
Eloy
Jean Anderson
JA
Department of Otolaryngology-Head and Neck Surgery, Mount Sinai School of Medicine, New York, New York 10029, USA.
Altman
Jason I
JI
Hoch
Benjamin L
BL
Munoz
Carla M
CM
Shohet
Michael R
MR
D000273:Adipose Tissue / Q000637:transplantation*; D000818:Animals; D001843:Bone Cements / Q000627:therapeutic use*; D002130:Calcium Phosphates / Q000627:therapeutic use*; D004195:Disease Models, Animal; D005626:Frontal Sinus; D019736:Prostheses and Implants; D011817:Rabbits; D014182:Transplantation, Autologous
D001843:Bone Cements; D002130:Calcium Phosphates; C020243:calcium phosphate