Bioactive glass hydroxyapatite in fronto-orbital defect reconstruction.
BACKGROUND
Synthetic bioactive ceramics and glasses have osteoconductive properties. These materials are capable of chemically bonding to the bone tissue. In addition, special bioactive glasses do not favor microbial growth. In this study, the clinical outcome of bioactive glass and hydroxyapatite in head and neck surgery was evaluated.


METHODS
In a retrospective series of 150 patients, 62 patients underwent reconstruction with frontal sinus obliteration after chronic frontal sinusitis, 65 patients were operated on for fronto-orbital traumas, and 23 patients underwent reconstruction after fronto-orbital tumor resections. These patients were evaluated for surgical procedures, reconstruction materials, complications, and functional outcomes.


RESULTS
Three of the 62 frontal sinus occlusions underwent operation (4.8 percent) during the follow-up of 5 years. The reoperations were caused by a new mucocele. In fronto-orbital reconstructions, we have reoperated on the orbital floor in four cases (7 percent). All 12 benign tumor patients and six of 11 malignant tumor patients survived during a follow-up of 3 years. Two of the 23 (9 percent) complicated tumor and trauma patients underwent reoperation because of a local mucocele.


CONCLUSIONS
Treatment of severe head and neck defects with biomaterial is a suitable alternative to conventional methods. Bioactive materials seem to be stable and reliable at clinical follow-up. The reconstructions with bioactive glass and hydroxyapatite are associated with good functional and aesthetic results without donor-site morbidity. However, more long-term outcomes of studied biomaterials are needed to determine whether they are capable of competing with traditional tissue grafts.
Aitasalo
Kalle M J
KMJ
Turku, Finland From the Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital.
Peltola
Matti J
MJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D018786:Bone Substitutes; D002648:Child; D017886:Durapatite; D005260:Female; D005624:Frontal Bone / Q000293:injuries / Q000601:surgery*; D005626:Frontal Sinus / Q000601:surgery; D015522:Frontal Sinusitis / Q000601:surgery; D005898:Glass; D006801:Humans; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D009078:Mucocele / Q000601:surgery; D009915:Orbit / Q000601:surgery*; D009918:Orbital Neoplasms / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000295:instrumentation*; D012008:Recurrence; D012189:Retrospective Studies; D012888:Skull Neoplasms / Q000601:surgery
D018786:Bone Substitutes; D017886:Durapatite