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Split-rib reconstruction of the frontal sinus: two cases and literature review

Published online by Cambridge University Press:  06 October 2011

M B Soyka ,
M Guggenheim ,
A Arnoux  and
D Holzmann
M B Soyka*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, University Hospital Zurich, Switzerland
M Guggenheim
Affiliation:
Department of Plastic and Reconstructive Surgery, University Hospital Zurich, Switzerland
A Arnoux
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Kantonsspital Aarau, Switzerland
D Holzmann
Affiliation:
Department of Otolaryngology Head and Neck Surgery, University Hospital Zurich, Switzerland
*
Address for correspondence: Dr Michael B Soyka, Department of Otolaryngology Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland Fax: +41 44 255 45 56 E-mail: michael@soyka.ch
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Abstract

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.

Conclusion:

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.

Keywords

Frontal SinusOsteomyelitisRibsReconstructive Surgical Procedures

Information

Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 12 , December 2011 , pp. 1301 - 1308
Copyright
Copyright © JLO (1984) Limited 2011

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References

1Grundmann, T, Kehrl, W. Reconstruction of the frontal sinus with a calvarium split galea periosteum transplant after inflammatory complications [in German]. HNO 2004;52:57–62CrossRefGoogle ScholarPubMed
2Artico, M, Ferrante, L, Pastore, F, Ramundo, EO, Cantarelli, D, Scopelliti, D. Bone autografting of the calvaria and craniofacial skeleton: historical background, surgical results in a series of 15 patients, and review of the literature. Surg Neurol 2003;60:71–9CrossRefGoogle Scholar
3Edwards, M, Ousterhout, D. Autogeneic skull bone grafts to reconstruct large or complex skull defects in children and adolescents. Neurosurgery 1987;20:273–80CrossRefGoogle ScholarPubMed
4Baumeister, S, Peek, A, Friedman, A, Levin, L, Marcus, J. Management of postneurosurgical bone flap loss caused by infection. Plast Reconstr Surg 2008;122:195–208eCrossRefGoogle ScholarPubMed
5Sahoo, N, Roy, I, Desai, A, Gupta, V. Comparative evaluation of autogenous calvarial bone graft and alloplastic materials for secondary reconstruction of cranial defects. J Craniofac Surg 2010;21:79–82CrossRefGoogle ScholarPubMed
6Beekmans, S, Don Griot, J, Mulder, J. Split rib cranioplasty for aplasia cutis congenita and traumatic skull defects: more than 30 years of follow-up. J Craniofac Surg 2007;18:594–7CrossRefGoogle ScholarPubMed
7Munro, I, Guyuron, B. Split-rib cranioplasty. Ann Plast Surg 1981;7:341–6CrossRefGoogle ScholarPubMed
8Longacre, J, Destefano, G. Further observations of the behavior of autogenous split-rib grafts in reconstruction of extensive defects of the cranium and face. Plast Reconstr Surg 1957;20:281–96CrossRefGoogle ScholarPubMed
9Leivy, D, Tovi, D. Autogenous bone cranioplasty. Neurochirurgia (Stuttg) 1970;13:82–6Google ScholarPubMed
10Körlof, B, Nylén, B, Rietz, K. Bone grafting of skull defects. A report on 55 cases. Plast Reconstr Surg 1973;52:378–83CrossRefGoogle ScholarPubMed
11Marchac, D, Cophignon, J. Technique for embedding split ribs in a cranioplasty. Plast Reconstr Surg 1975;55:237–9CrossRefGoogle Scholar
12Shaw, R, Thering H. Reconstruction of cranial defects. Clin Plast Surg 1975;2:539–49CrossRefGoogle ScholarPubMed
13Steinhäuser, E, Hardt, N. Secondary reconstruction of cranial defects. J Maxillofac Surg 1977;5:192–8CrossRefGoogle ScholarPubMed
14Cabbabe, E, Shively, R, Malik, P. Cranioplasty for traumatic deformities of the frontoorbital area. Ann Plast Surg 1984;13:175–84CrossRefGoogle ScholarPubMed
15Stueber, K, Salcman, M, Spence, R. The combined use of the latissimus dorsi musculocutaneous free flap and split-rib grafts for cranial vault reconstruction. Ann Plast Surg 1985;15:155–60CrossRefGoogle ScholarPubMed
16Forte, V, de Souza, F. Autogenous rib grafts in facial surgery. J Otolaryngol 1985;14:201–2Google ScholarPubMed
17Argenta, L, Dingman, R. Total reconstruction of aplasia cutis congenita involving scalp, skull, and dura. Plast Reconstr Surg 1986;77:650–3CrossRefGoogle ScholarPubMed
18Chicarilli, Z, Ariyan, S. Cranioplasty with a silicone prosthesis and split rib grafts. Head Neck Surg 1986;8:355–62CrossRefGoogle ScholarPubMed
19Pochon, J, Klöti, J. Cranioplasty for acquired skull defects in children – a comparison between autologous material and methylmethacrylate 1974–1990. Eur J Pediatr Surg 1991;1:199–201CrossRefGoogle ScholarPubMed
20Stal, S, Netscher, D, Shenaq, S, Spira, M. Reconstruction of calvarial defects. South Med J 1992;85:812–19CrossRefGoogle ScholarPubMed
21Viterbo, F, Palhares, A, Modenese, E. Cranioplasty: the autograft option. J Craniofac Surg 1995;6:80–3CrossRefGoogle ScholarPubMed
22Taggard, D, Menezes, A. Successful use of rib grafts for cranioplasty in children. Pediatr Neurosurg 2001;34:149–55CrossRefGoogle ScholarPubMed
23Goiato, M, Anchieta, R, Pita, M, dos Santos, D. Reconstruction of skull defects: currently available materials. J Craniofac Surg 2009;20:1512–18CrossRefGoogle ScholarPubMed
24Hancock, D. The fate of replaced bone flaps. J Neurosurg 1963;20:983–4CrossRefGoogle ScholarPubMed
25Manson, P, Crawley, W, Hoopes, J. Frontal cranioplasty: risk factors and choice of cranial vault reconstructive material. Plast Reconstr Surg 1986;77:888–904CrossRefGoogle ScholarPubMed
26Snyderman, C, Janecka, I, Sekhar, L, Sen, C, Eibling, D. Anterior cranial base reconstruction: role of galeal and pericranial flaps. Laryngoscope 1990;100:607–14CrossRefGoogle ScholarPubMed
27Weber, R, Kearns, D, Smith, R. Split calvarium cranioplasty. Arch Otolaryngol Head Neck Surg 1987;113:84–9CrossRefGoogle ScholarPubMed
28Bagby, G. Compression bone-plating: historical considerations. J Bone Joint Surg Am 1977;59:625–31CrossRefGoogle ScholarPubMed
29Longacre, J, Destefano, G. Experimental observations of the repair of extensive defects of the skull with split-rib grafts. Plast Reconstr Surg Transplant Bull 1958;21:372–88CrossRefGoogle ScholarPubMed
30Tessier, P, Kawamoto, H, Matthews, D, Posnick, J, Raulo, Y, Tulasne, JF et al. Taking long rib grafts for facial reconstruction – tools and techniques: III. A 2900-case experience in maxillofacial and craniofacial surgery. Plast Reconstr Surg 2005;116(Suppl. 5):38S–46S, 92–4SCrossRefGoogle Scholar
31Whitaker, L, Munro, I, Salyer, K, Jackson, I, Ortiz-Monasterio, F, Marchac, D. Combined report of problems and complications in 793 craniofacial operations. Plast Reconstr Surg 1979;64:198–203CrossRefGoogle ScholarPubMed
32James, D, Irvine, G. Autogenous rib grafts in maxillofacial surgery. J Maxillofac Surg 1983;11:201–3CrossRefGoogle ScholarPubMed
33Gosain, A, Committee PSEFD. Biomaterials for reconstruction of the cranial vault. Plast Reconstr Surg 2005;116:663–6CrossRefGoogle ScholarPubMed
34Friedman, C, Costantino, P, Synderman, C, Chow, L, Takagi, S. Reconstruction of the frontal sinus and frontofacial skeleton with hydroxyapatite cement. Arch Facial Plast Surg 2000;2:124–9CrossRefGoogle ScholarPubMed
35Mann, W, el-Khatieb, A. Cranioplasty with Palacos R® in reconstruction of frontal sinus defects. J Laryngol Otol 1988;102:824–7CrossRefGoogle ScholarPubMed
36Kuttenberger, J, Hardt, N. Long-term results following reconstruction of craniofacial defects with titanium micro-mesh systems. J Craniomaxillofac Surg 2001;29:75–81CrossRefGoogle ScholarPubMed
37Lethaus, B, Poort Ter Laak, M, Laeven, P, Beerens, M, Koper, D, Poukens, J et al. A treatment algorithm for patients with large skull bone defects and first results. J Craniomaxillofac Surg 2010;39:435–40CrossRefGoogle ScholarPubMed
38Grocott, J. Experiences in cranial bone grafting. Br J Plast Surg 1952;5:51–9CrossRefGoogle ScholarPubMed