Extensive resection of a giant sinus osteoma in a 73-year-old patient with exophthalmos

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<b>Introduction:</b> Osteomas are among the most common non-epithelial benign tumours of the facial skeleton, most often of the paranasal sinuses. They are usually asymptomatic and detected accidentally during head imaging tests. Sometimes, however, they cause severe conditions such as headaches, vision deficiencies, or facial deformation.<b>Case report:</b> This study presents the case of a 73-year-old patient who consulted a doctor due to increasing exophthalmos of the right eye, nasal congestion, and recurrent headaches. A computed tomography (CT) scan of the paranasal sinuses revealed an extensive, calcified, irregularly shaped pathological mass filling these structures. The lesion was completely excised using an external approach. Histopathological examination confirmed the clinical diagnosis of osteoma.<b>Discussion:</b> The case report reviews the literature, describes the most common locations of osteomas in the paranasal sinuses, includes possible etiopathogenesis, and compares surgical methods.<b>Conclusions:</b> Symptoms associated with osteomas in the craniofacial region depend on their size and location. The method of choice in symptomatic cases is surgical removal. Medical imaging can help decide on the surgical procedure. Endoscopic excision is less traumatic for patients and facilitates tissue healing. Due to the large extent of the tumour, its specific location, and the patient’s health condition, an external surgical approach may be necessary.