Split-rib reconstruction of the frontal sinus: two cases and literature review.
BACKGROUND
Large defects of the anterior wall of the frontal sinus require closure using either autologous or foreign material. In cases of osteomyelitis, the reconstruction must be resistant to bacterial infection. Split-rib osteoplasty can be used in different sites.


METHODS
Two patients with malignant sinonasal tumours underwent repeated treatment, and subsequently developed osteomyelitis of the frontal bone. After adequate therapy, a large defect of the anterior wall persisted. Reconstruction was performed using the split-rib method. The literature on this topic was reviewed.


RESULTS
Both patients' treatment were successful. No complications occurred. A PubMed search on the topic of rib reconstruction of the frontal sinus and skull was performed; 18 publications matched the inclusion criteria. From these sources, we noted that 182 reconstructions yielded good results with few complications.


CONCLUSIONS
Large defects of the anterior wall of the frontal sinus can be closed successfully using autologous split-rib grafting. Aesthetic outcome is good and donor site morbidity is minimal.
Department of Otolaryngology Head and Neck Surgery, University Hospital Zurich, Switzerland. michael@soyka.ch
M B
MB
Soyka
M
M
Guggenheim
A
A
Arnoux
D
D
Holzmann
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001860:Bone Plates / Q000009:adverse effects; D016025:Bone Transplantation / Q000379:methods; D002277:Carcinoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D060826:Cementoplasty / Q000009:adverse effects; D003131:Combined Modality Therapy; D005260:Female; D005624:Frontal Bone / Q000601:surgery; D005626:Frontal Sinus / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009669:Nose Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D010000:Osteitis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D010019:Osteomyelitis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012086:Reoperation; D012272:Ribs / Q000637:transplantation; D054364:Solitary Fibrous Tumors / Q000532:radiotherapy / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents