Demineralized Bone Matrix and Fat Autograft in a Rabbit Model of Frontal Sinus Obliteration

Abstract

OBJECTIVE: In this study, we investigate the efficacy of demineralized bone matrix (DBM) as a material for frontal sinus obliteration in a rabbit model.

STUDY DESIGN AND SETTING: Twenty-four New Zealand White rabbits were divided into four groups, and the study was carried out to two time periods. Twelve rabbits underwent frontal sinus obliteration with fat autograft, and 12 rabbits underwent the procedure with DBM. At 12 weeks, six control and six study rabbits were killed. The remaining 12 rabbits were killed at 36 weeks. All specimens underwent radiologic evaluation with spiral CT followed by histologic examination for evidence of bony growth.

RESULTS: Sinuses obliterated with DBM showed replacement of the sinus cavity by trabecular bone. Histology demonstrated significant progressive replacement of DBM by cancellous bone from 12 weeks (53.3%) to 36 weeks (78.8%). There were no complications observed as a result of the materials used.

CONCLUSION AND SIGNIFICANCE: DBM is a prospective material for frontal sinus obliteration. Long-term studies and human trials will further elucidate the role of this material.

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References

Bergara

Itoiz

Experimental study of the behavior of adipose tissue within the frontal sinus of dogs. Argent Rev Otorhinolaryngol 1951;12:184–92.

Bergara

Itoiz

Present state of the surgical treatment of chronic frontal sinusitis. Arch Otolaryngol 1955;61:616–28.

Goodale

Montgomery

Experiences with the osteoplastic anterior wall approach to the frontal sinus. Arch Otolaryngol 1958:271–83.

Goodale

Montgomery

Anterior osteoplastic frontal sinus operation. Ann Otol Rhinol Laryngol 1961;70:860–80.

Metson

Sindwani

Endoscopic surgery for frontal sinusitis-a graduated approach. Otolaryngol Clin N Am 2004;37(2):411–22.

Owens

Klotch

Use of bone for obliteration of the nasofrontal duct with the osteoplastic flap: A cat model. Laryngoscope 1993;103(8):883–9.

McNeil

Surgical obliteration of the frontal sinus. Laryngoscope 1967;77:202–17.

Nadell

Kline

Primary reconstruction of depressed frontal skull fractures including those involving the sinus, orbit and cribriform plate. J Neurosurg 1974;41(2):200–7.

Manson

Crawley

Hoopes

Frontal cranioplasty: Risks factors and choice of cranial vault reconstructive material. Plast Reconstr Surg 1986;77(6):888–904.

10.

Sataloff

Sariego

Myers

. Surgical management of the frontal sinus. Neurosurgery 1984;15(4):593–6.

11.

Ducic

Stone

Frontal sinus obliteration using a laterally based pedicled pericranial flap. Laryngoscope 1999;109(4):541–5.

12.

Knauff

Single-stage frontal sinus obliteration. Bone graft plastic repair. Arch Otolaryngol 1963;78:707–14.

13.

Goodale

Obliteration of the frontal sinus. Ann Otol Rhinol Laryngol 1965;74(3):831–40.

14.

Grahne

Chronic frontal sinusitis treated by autogenous osteoplasty. Acta Otolaryngol 1971;72(3):215–9.

15.

Shumrick

Smith

The use of cancellous bone for frontal sinus obliteration and reconstruction of frontal bony defects. Arch Otolaryngol Head Neck Surg 1994;120(9):1003–9.

16.

Schenck

Tomlinson

Ridgley

Experimental evaluation of a new implant material in frontal sinus obliteration. Arch Otolaryngol 1976;102(9):524–8.

17.

Friedman

Costantino

Jones

. Hydroxyapatite cement. II: Obliteration and reconstruction of the cat frontal sinus. Arch Otolaryngol 1991;117(4):385–9.

18.

Snyderman

Scioscia

Carrau

. Hydroxyapatite: An alternative method of frontal sinus obliteration. Otolaryngol Clin N Am 2001;34(1):179–91.

19.

Petruzzelli

Stankiewicz

Frontal sinus obliteration with hydroxyapatite cement. Laryngoscope 2002;112(1):32–6.

20.

Peltola

Aitasalo

Suonpaa

. In Vivo Model for frontal sinus and calvarial bone defect obliteration with bioactive glass S53P4 and hydroxyapatite. J Biomed Mater Res Appl Biomater 2001;58(3):261–9.

21.

Peltola

Aitasalo

Suonpaa

. Frontal sinus and skull bone defect obliteration with three synthetic bioactive materials. A comparative study. J Biomed Mater Res Appl Biomater 2003;66(1):364–72.

22.

DBX® Demineralized Bone Matrix, Putty, Paste, & Mix. Musculoskeletal Transplant Foundation. 2005.

23.

Peterson

Whang

Iglesias

. Osteoinductivity of commercially available demineralized bone matrix. Preparations in a spine fusion model. J Bone Joint Surg Am 2004;86-A(10):2243–50.

24.

Bender

Rogalski

Mills

. Evaluation of demineralized bone matrix paste and putty in periodontal intraosseous defects. J Periodontol 2005;76(5):768–77.

25.

Acarturk

Hollinger

Commercially available demineralized bone matrix compositions to regenerate calvarial critical-sized bone defects. Plast Reconstr Surg 2006;118(4):862–73.