Bioactive Glass in Fronto-orbital and Skull Surgery

Introduction: Synthetic osteoconductive and antimicrobial bioactive glass (BAG) has been used in many surgical applications because it is capable of chemically bonding to the bone tissue and new bone formation is possible in the bony defects. In this study we evaluate the clinical outcome of BAG in craniofacial surgery.

Material and Methods: In a retrospective series, 204 patients were treated from 1991 to 2006 on our ENT department. Three patients underwent skull reconstructions, 69 patients underwent frontal sinus obliteration due to chronic frontal sinusitis, 92 patients were operated on for fronto-orbital trauma, 31 patients were reconstructed after fronto-orbital tumor resections, and 9 patients had ear infection in temporal bone. After surgical procedures using reconstruction techniques with BAG, complications and functional outcomes were evaluated.

Results: All skull reconstructions were successfully functional and aesthetic. Three of the 69 frontal sinus occlusions were reoperated (3%) during the follow-up of 5 years. The reoperations were caused by a new mucocele. In the group of fronto-orbital trauma patients, 8 cases (8%) were reoperated during the follow-up over 1 year. Fourteen of 15 benign tumor and 10 of 16 malignant tumor patients survived during the follow-up of 4 years. All the temporal bone occlusions have been successful.

Conclusions: Treatment of severe craniofacial defects with BAG is an alternative material to the conventional methods. BAG is easy to handle during operations. Furthermore, BAG seems to be stable and reliable during clinical follow-up. The reconstructions with BAG are associated with good functional and aesthetic results without donor-site morbidity.