Abstract
IntroductionOsteomas of the paranasal sinuses are benign bone tumours that produce clinical signs depending on their size and location. In most reported cases large tumours are excised by an external approach or in conjunction with an endoscopic technique. Endoscopic treatment of such tumours is a huge challenge for the operator. ObjectiveDetermine the optimal surgical approach by analysing giant osteomas of the frontal and ethmoidal sinuses in the literature. MethodsGroup of 37 osteomas obtained from the literature review. A group of osteomas removed only by endoscopy was compared with a group in which an external approach (lateral rhynotomy or craniotomy) or combined external and endoscopic approach was applied. ResultsThe authors, based on the statistical analysis of the literature data, have found that the average size of osteomas excised endoscopically and those removed by external approaches does not differ statistically, when the osteomas are located in the ethmoidal cells (p=0.2691) and the frontal sinuses (p=0.5891). ConclusionThe choice of surgical method appears to be independent of the osteoma size and the decision is likely to be taken based on the experience of the surgeon, available equipment and knowledge of different surgical techniques.
Highlights
Osteomas are frequent, benign osteogenic tumours of connective tissue arising from the proliferation of cancellous or cortical bone.[1,2] Craniofacial osteomas occur frequently, especially in the paranasal sinuses
This paper presents the case of a fronto-ethmoidal giant osteoma successfully removed via endoscopy without intraoperative and postoperative complications
Among the collected literature data, including the case described by the authors, 31.58% of all osteomas were localized in the ethmoidal cells and excised endoscopically, a similar amount (34.21%) constituted osteomas located in the ethmoidal cells and removed by an external approach
Summary
Benign osteogenic tumours of connective tissue arising from the proliferation of cancellous or cortical bone.[1,2] Craniofacial osteomas occur frequently, especially in the paranasal sinuses. Due to their slow asymptomatic growth, in most cases they are detected accidentally, in 3% of computed tomography (CT) scans and 1% of radiographs of the sinuses.[3]. Osteomas of the maxillary sinus occur in 5% of cases.[2] Orbital involvement is the result of the spread of an osteoma from the neighbouring sinuses. Primary orbital involvement is exceedingly rare.[4]
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