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Magnetic resonance imaging after frontal sinus surgery with fat obliteration

Published online by Cambridge University Press:  29 June 2007

R. Keerl ,
R. Weber ,
G. Kahle ,
W. Draf ,
J. Constantinidis  and
A. Saha
R. Keerl*
Affiliation:
Departments of Otolaryngology, Head, Neck and Facial Plastic Surgery and Communication Disorders, Hospital Fulda, Fulda, Germany
R. Weber
Affiliation:
Departments of Otolaryngology, Head, Neck and Facial Plastic Surgery and Communication Disorders, Hospital Fulda, Fulda, Germany
G. Kahle
Affiliation:
Departments of Otolaryngology, Communication Disorders and the Institute of Radiology, Hospital Fulda, Fulda, Germany
W. Draf
Affiliation:
Departments of Otolaryngology, Head, Neck and Facial Plastic Surgery and Communication Disorders, Hospital Fulda, Fulda, Germany
J. Constantinidis
Affiliation:
Departments of Otolaryngology, Head, Neck and Facial Plastic Surgery and Communication Disorders, Hospital Fulda, Fulda, Germany
A. Saha
Affiliation:
Departments of Otolaryngology, Departments of Communication Disorders and the Institute of Radiology, Peerless Hospitals, Calcutta, India
*
Dr Rainer Keerl, Department of Otolaryngology, Head, Neck and Facial Plastic Surgery and Communication Disorders, Hospital Fulda, Pacelliallee 4, D 36043 Fulda, Germany. Fax: 0661-842583
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Abstract

The obliteration of the frontal sinus via an osteoplastic approach is performed with the aim of achieving a permanent ‘switching off’ by final and conclusive clearing out. For this, freshly harvested abdominal fat has shown itself to be the best clinically. It is possible to demonstrate the vitality of fat transplanted into the frontal sinus without an operation i.e. by a macroscopical and histological examination using magnetic resonance imaging (MRI). The magnetic resonance examinations were carried out on a supraconductive 0.5 T Magnet (Gyroscan T.S.II, Philips Medicine Systems, Eindhoven, Netherlands) with a quadrature (square) head spool. We produced T1-weighted spin echo images (TR: 450–550 ms; TE: 20–25 ms), T2-weighted fast spin echo images or in double-echo technique in transverse orientation (Turbo SE or TR: 2000–2500 ms; TE: 50–90 ms) and short tau inversion recovery (STIR) sequences for fat suppression (TJ: 140 ms; TR: 1400 ms; TE: 30 ms). The fat implanted into the frontal sinus of 11 patients aged 22–65 years, having undergone an osteoplastic frontal sinus operation with obliteration, was examined post-operatively by MRI. Objectives were the time-dependent distribution of portions of vital fatty or connective tissue, the eventual development of necroses or cysts as well as recurrences, inflammatory complications or re-epithelization of the frontal sinus four to 24 months postoperatively. In only six out of 11 cases was vital fatty tissue found. Fatty necrosis occurred five times, whereas in four cases a transformation into granulation tissue and in one case into connective tissue could be seen. All 11 patients were complaint-free. Long-term observations are needed to see if differences in the recurrence rate of frontal sinus disease are dependent on whether the implanted fat remains vital or necrosed and transformed.

Keywords

Frontal sinussurgeryMagnetic resonance imagingFat
Type
Radiology in Focus
Information
The Journal of Laryngology & Otology , Volume 109 , Issue 11 , November 1995 , pp. 1115 - 1119
Copyright
Copyright © JLO (1984) Limited 1995

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