Frontal sinus obliteration with an allograft.

The osteoplastic flap technique as an approach to the frontal sinus has been a well-established concept since the 19th century. However, obliteration of the frontal sinus with homografts or allografts is a relatively modern contribution. All techniques preserve and replace the anterior bony frontal sinus wall, acting as a trapdoor to the obliteration material. In the technique described, a synthetic material (polymethacrylate)is used to obliterate the frontal sinus. The bony anterior frontal sinus wall (osteoplastic flap) is not replaced. The synthetic material is easily sculptured (manually or with a power drill) to the contour of the forehead. This procedure is time-saving and reduces surgical morbidity. A concomitant and separate abdominal incision to obtain a free fat implant becomes superfluous.