Bioactive glass S53P4 in frontal sinus obliteration.: A 9-year experience

Many alloplastic materials have been used in clinical frontal sinus obliteration. It has been difficult to find reliable obliteration material without short- or long term complications. Most common problem in frontal sinus obliteration is the resorption of occlusion material. Bioactive glass S53P4 (BG) has been used as obliteration material in series of osteoplastic frontal sinus operation on 32 patients from 1990 to 1999 in our ENT Department. Five consecutive patients of this material were accurately controlled by CT scans at one week, 6, 12, 24, 36, 48 months and analysed with Region of Interest (ROI). Also in three cases at 12, 18 months and 8 years we have got histopathologic samples. The average yearly decrease in Hounsfield Units (HU) was 7.1-18.7%, The decrease was similar on the surface and in the middle of the BG-mass. The histopathologic samples after 12 and 18 months showed dense fibrous tissue between the granules but no inflammatory changes. Eight years after obliteration the clinical status and CT scan were normal and in histopathologic examination there was a clear woven bone formation and no inflammatory or foreign body reactions. BG is a good and well tolerated bone substitute for osteoplastic frontal sinus operations. The results of the obliteration are maintained owing to the stability of the material and a new bone formation capacity.