The frontal sinus is opened via a bicoronal osteoplastic flap approach. The fistula from the sinus to the anterior cranial fossa is identified. The infected bone is curetted and smoothed with a drill. The fistula is obliterated with BoneSource®, a substance that resembles plaster of Paris.
This patient presented with meningitis. Axial CT scan of the frontal sinus showed severe erosion of the posterior table of the frontal sinus and a fistula into the anterior cranial fossa.
BoneSource® is mixed into a paste-like consistency.
The osteoplastic flap is closed with miniplates and screws.
BoneSource®, a calcium phosphate bone cement used to repair and heal cranial defects, began commercial use in November 1997. This Food and Drug Administration (FDA)-approved product was the first material of its kind made available for clinical use. Since its introduction, the material has become widely used in medical centers and may be useful for a vast number of additional clinical applications.