Effect of the Bone wax for the Maintenance of a Created Fistula between the Maxillary Sinus and the Nasal Cavity in Rabbits

ABSTRACT

PURPOSE: To investigate whether the bone wax could maintain the created fistula between the maxillary sinus and the nasal cavity in a rabbit model of dacryocystorhinostomy. METHODS: After creating a fistula between the maxillary sinus and the nasal cavity at both sides in 20 rabbits, the one on the right side was plugged with bone wax (treated side) and the one on the left side was used as a control. Five rabbits were sacrificed each time at 1, 2, 4 weeks after surgery. Bone wax was removed at 4weeks after surgery in 5 rabbits and they were sacrificed 2 weeks later. The state of the fistulas and the histopathology were observed. RESULTS: Among controls, only one of the rabbits sacrificed at 1 and 2 weeks after surgery, showed partially open fistula and all other rabbits showed closure of fistula. The treated fistulas were opened in 4 rabbits at 1 week, in 3 rabbits at 2 weeks, and 4 rabbits at 4weeks after surgery. Two out of 5 treated fistulas which had the removal of the bone wax 4 weeks later showed open fistula. The epithelial lining of the opened treated fistula was observed at 4 weeks after surgery. There was no significant difference in the amount of discharge within the maxillary sinus or the degree of inflammation around the fistula between the treated and the control sides. CONCLUSIONS: The bone wax may be used as a new stent in maintaining a created fistula during dacryocystorhinostomy.