The Effects of Sinus Surgery on Midfacial Growth in the Rabbit

Abstract

The effects of pediatric sinus surgery on craniofacial growth have not been established. This study was designed to determine whether sinus surgery influences midfacial growth in New Zealand white rabbits. Surgery was performed on five groups of six rabbits each: Group 1—bilateral external dorsal approach to the maxillary sinus with enlargement of the sinus ostium and removal of the uncinate process; Group 2—bilateral external dorsal approach to the maxillary sinus; Group 3—unilateral external dorsal approach to the maxillary sinus with enlargement of the sinus ostium and removal of the uncinate process; Group 4—unilateral external dorsal approach to the maxillary sinus; Group 5—no operation. Rabbits were killed as adults, and dried skull measurements were performed using a Polhemus 3-space digitizer. Statistically significant regional restriction of midfacial growth was demonstrable when comparing Groups 1–4 with Group 5, and between sides in Groups 3–4. Enlargement of the sinus ostium and uncinectomy caused foreshortening of the snout on the operated side in Group 3. This effect was not observed following the approach alone in Group 4. These results suggest that midfacial growth is affected by sinus surgery in rabbits. Further animal studies should be done to test this hypothesis, and in the interim, a conservative approach to sinus surgery in children would be prudent.