Chronic frontal sinus disease: Combined use of platelet-rich plasma and calvarial bone grafts for sinus obliteration in aggressive and secondary cases

Abstract

The surgical management of chronic frontal sinusitis can be challenging. The most effective way to treat this condition is sinus obliteration. Several methods have been published. We evaluated the feasibility of a combined treatment, consisting of platelet-rich plasma (PRP) and autologous calvarial bone chips, in chronic frontal sinus diseases (CFSD). From January 2001 to June 2006, seven patients (four women and three men) were admitted presenting with signs and symptoms of CFSD. Their ages ranged from 35 to 67 years. Two patients presented with signs of frontal osteomyelitis and a cutaneous fistula, while endoscopic drainage had failed for five patients. All patients were treated by sinus obliteration though bicoronal access. Free autologous calvarial bone graft combined with PRP was used to repair the frontal sinus. The frontal sinus repair was successful in all seven patients with progressive resolution of symptoms without perioperative complication. The CT scans at 12 postoperative months showed complete obliteration of sinuses. Combined PRP and autologous bone graft is a safe and reliable procedure for frontal sinus obliteration. The low rate of complications and the absence of donor site morbidity support using this technique in secondary and particularly complex cases.