Paranasal Sinus Involvement Research Articles

Actinomycotic Osteomyelitis of Maxilla Presenting as Oroantral Fistula: A Rare Case Report.

Actinomycosis is a chronic granulomatous infection caused by Actinomyces species which may involve only soft tissue or bone or the two together. Actinomycotic osteomyelitis of maxilla is relatively rare when compared to mandible. These are normal commensals and become pathogens when they gain entry into tissue layers and bone where they establish and maintain an anaerobic environment with extensive sclerosis and fibrosis. This infection spreads contiguously, frequently ignoring tissue planes and surrounding tissues or organ. The portal of entry may be pulpal, periodontal infection, and so forth which may lead to involvement of adjacent structures as pharynx, larynx, tonsils, and paranasal sinuses and has the propensity to damage extensively. Diagnosis is often delayed and is usually based on histopathology as they are cultured in fewer cases. The chronic clinical course without regional lymphadenopathy may be essential in diagnosis. The management of actinomycotic osteomyelitis is surgical debridement of necrotic tissue combined with antibiotics for 3–6 months. The primary actinomycosis arising within the maxilla with contiguous involvement of paranasal sinus with formation of oroantral fistula is rare. Hence, we present a 50-year-old female patient with chronic sclerosing osteomyelitis of maxilla which presented as oroantral fistula with suppurative and sclerotic features.

Wegener′s granulomatosis disease mimicking pulmonary tuberculosis

Wegener's granulomatosis (WG) is an uncommon autoimmune disease with multi-system involvement that manifests as vasculitis, granulomatosis, and necrosis. While its standard form involves the upper and lower respiratory tracts and kidneys, it may essentially involve any organ. We present a case in a young female patient presenting with symptoms of cough with expectoration, fever, dyspnea and chest discomfort, having cavitating lesion in right upper lobe and nodule in left upper lobe with bilateral paranasal sinus involvement on computed tomography. Allergic rhino-sinusitis with pulmonary tuberculosis was suspected, and patient was investigated further. Upon further investigation, renal involvement was detected, and serology revealed cytoplasmic antineutrophil cytoplasmic antibody. WG was suspected and was proven by histopathology of nasal tissue which revealed necrotizing granulomas.

Patterns of Central Nervous System Relapse in Peripheral T-Cell Lymphomas – Population-Based Data from the Swedish Lymphoma Registry

IntroductionDisease relapse involving the central nervous system (CNS) carries a dismal prognosis in patients with aggressive lymphoma. Risk factors for CNS-relapse have included involvement of lymphoma at specific anatomical sites, proliferation rate and high tumor burden. The risk and importance of CNS-relapse in peripheral T-cell lymphomas (PTCL) has been very little studied. So far, the only study focusing on CNS-relapse in PTCL found elevated LDH and paranasal sinus involvement to be independent risk factors and that CNS-relapse was associated with an inferior survival. Recently, several studies have highlighted the dismal prognosis of relapsed PTCL in general. In this study we aimed at analyzing risk factors for CNS involvement in first relapse and the outcome of these patients, in a large population-based cohort of PTCL patients.Materials and methodsThrough the Swedish Lymphoma Registry we identified all adult (>18 years) patients diagnosed with PTCL between January 1st 2000 and December 31st 2009. Primary cutaneous, primary leukemic types and T-cell lymphoblastic lymphoma were excluded. Information on first relapse was collected from patient files retrospectively after informed consent.ResultsOut of 755 patients identified through the registry, 10 patients had CNS involvement at diagnosis and were excluded from further analyses. Data on first relapse was available for 618, and among these 369 patients experienced relapse or progression. Thirty-one patients (5.0 %) experienced progression or relapse involving the CNS after a median time of 4.3 months (range 1.1-45 months) from diagnosis. Thirteen patients experienced an isolated CNS relapse/progression and 18 as part of a systemic relapse. Sixteen patients relapsed after responding to primary therapy (10 CR, 6 PR), and 15 patients with refractory disease had CNS-progression (1 SD, 14 PD). Histologic subtypes among the 31 patients were ALK-positive anaplastic large cell lymphoma (ALCL) (n=3), ALK-negative ALCL (n=3), ALK-unknown ALCL (n=1), angioimmunoblastic T-cell lymphoma (n=3), peripheral T-cell lymphoma NOS (n=13), enteropathy-associated T-cell lymphoma (n=3), NK/T-cell lymphoma nasal type (n=1), hepatosplenic T-cell lymphoma (n=1) and unclassified T-cell lymphoma (n=1). All 31 patients had received chemotherapy with curative intent and 6 received intrathecal prophylaxis. In multivariable analysis, the presence of B-symptoms (HR 2.79 95% CI 1.14-6.82, p=0.024), >1 extranodal site of disease (HR 3.28[1.41-7.64], p=0.006) and skin involvement (HR 3.06 [1.10-8.49], p=0.032) were independent risk factors for CNS relapse.Median survival for patients with CNS involvement at relapse or progression was 3.3 months (range 0-124) compared to 3.7 (range 0-129) for patients without CNS involvement and CNS involvement was not a risk factor for OS after relapse/progression (HR 1.08 [0.73-1.59], p=0.700).For relapsing patients only age was predictive of inferior survival (1.014 [1.002-1.027], p=0.026) whereas in patients with primary refractory disease, male gender predicted inferior survival (2.93 [1.54-5.58], p=0.001) and angioimmunoblastic T-cell lymphoma was associated with better survival (0.41 [0.18-0.95], p=0.037).ConclusionsCNS involvement, isolated or as part of a systemic first relapse, occurred in 5% of the patients in our series, which is similar to the incidence in larger series dominated by B-cell lymphomas. In our cohort, B-symptoms, >1 extranodal site of disease and skin involvement were independent predictors for CNS-relapse. The outcome of relapsed patients was very poor in general, and CNS-involvement did not convey worse outcome compared to patients with systemic relapse only. With current treatment strategies the uncommon CNS-relapses seem to be a problem of lower magnitude compared to the frequent systemic relapses. Future improvements in the treatment of PTCLs could possibly increase the importance of identifying patients at risk for CNS-relapse, and our study provides data on this poorly described complication. DisclosuresNo relevant conflicts of interest to declare.

Histiocytosis: a review focusing on neuroimaging findings.

Histiocytosis is a systemic disease that usually affects the central nervous system. The aim of this study is to discuss the neuroimaging characteristics of Langerhans cell histiocytosis (LCH), the most common of these diseases; and the non-Langerhans cells histiocytosis (NLCH), which includes entities such as hemophagocytic syndrome, Erdheim-Chester and Rosai-Dorfman diseases. Literature review and illustrative cases with pathologic confirmation. In LCH, the most common findings are 1) osseous lesions in the craniofacial bones and/or skull base; 2) intracranial, extra-axial changes; 3) intra-axial parenchymal changes (white and gray matter); 4) atrophy. Among the NLCH, diagnosis usually requires correlation with clinical and laboratory criteria. The spectrum of presentation includes intraparenchymal involvement, meningeal lesions, orbits and paranasal sinus involvement. It is important the recognition of the most common imaging patterns, in order to include LCH and NLCH in the differential diagnosis, whenever pertinent.

Wegener’s Granulomatosis Presenting With an Isolated Paranasal Sinus Involvement in a Child

©2014 Turkish League Against Rheumatism. All rights reserved. Wegener’s granulomatosis (WG) is mostly seen in adults with ages between 20 and 50 without a sex predilection. It is a necrotizing granulomatous vasculitis mostly affecting the lungs (95%), paranasal sinuses (90%), kidneys (85%), nose or nasopharynx (65%), and joints (65%) accordingly.1-4 It is rarely seen in children.5,6 Childhood WG has many common findings with those of adult disease, especially respiratory tract and renal involvement. However, the disorder has a female predominance in children and less frequently involves joints and paranasal sinuses.7 Paranasal and thorax computed tomography (CT) can be used to support the diagnosis.8,9 The definite diagnosis is based on the presence of necrotizing granulomatous vasculitis in pulmonary, renal or paranasal sinus biopsy specimens.5 Here we report a previously healthy boy who presented with facial edema, a history of recurrent upper respiratory tract infection and recurrent sinusitis without any other complaints and findings, and who was later on diagnosed as having WG limited to the maxillary sinuses, without other systemic involvement.

Orbital aspergillosis in immunocompetent patients

PurposeTo describe clinical, ultrasonographic, radiological and histopathological features of orbital aspergillosis in immunocompetent patients.MethodsMedical records of immunocompetant individuals with orbital aspergillosis between November 1995 and November 2010 were reviewed.ResultsThirty-five cases...

Sinonasal melanoma: survival and prognostic implications based on site of involvement

Sinonasal melanoma (SNM) is a rare malignancy that commonly presents at an advanced age and has a slight male predominance. Local recurrence has been implicated as a major reason for treatment failure, and there are poor reported 5-year survival rates. We analyzed the impact of specific location within the sinonasal region on the survival of this rare malignancy. The U.S. National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) registry was used to extract data on SNM between 1973 and 2009. Survival trends and hazard ratios (HRs) were calculated to compare the prognostic implications of involvement of varying areas of the sinonasal tract. A total of 567 cases were identified. Females constituted 56.44% patient. Disease-specific survival (DSS) at 5 years was 36.66% for patients diagnosed with nasal cavity disease, 23.80% for patients with maxillary sinus tumors, and 18.20% for patients with ethmoid sinus disease. Patients showing evidence of overlapping sinus involvement had approximate 1-year survival of 54.45% and none survived beyond 49 months. HRs for maxillary sinus, ethmoid sinus, and overlapping sinus disease were 1.34, 1.60, and 2.30, respectively. All DSSs and HRs were statistically significant (p < 0.05). There was a higher proportion of earlier-stage disease in the nasal cavity compared to the most common paranasal sinus region (p < 0.05). Prognosis in SNM is dependent on the anatomic subsite. Paranasal sinus involvement indicates a poorer prognosis when compared to nasal cavity disease. Patients presenting with overlapping sinus involvement have the poorest prognosis.

Ossifying fibroma of the middle turbinate revealed by infection in a young child

Ossifying fibroma (OF) is a rare benign fibro-osseous tumor, mainly located in the head and neck region. Most often, it affects the mandible but rare involvement of paranasal sinuses has been reported, associated with more locally aggressive behavior. We report the case of an 8-year-old boy with OF of the middle turbinate, revealed by ethmoiditis. Total resection was performed on an endoscopic approach. The patient was free of clinical or radiological recurrence at 3 years' follow-up. This was the youngest patient with OF of the middle turbinate so far reported in the international literature. Presumptive diagnosis is established by clinical examination and CT scan (location, oval-shaped mass, heterogeneous tumor with a thin bony rim). Definitive diagnosis is founded on histological examination (psammomatous bodies, osteoblastic rim, trabecular bone). Treatment in paranasal sinus OF is surgical, preferentially on an endoscopic approach. Resection should be as complete as possible to minimize risk of recurrence, especially in sinonasal locations, known to be more aggressive. Ethmoiditis in an unusual age-range should suggest tumoral etiology.

Progressive Left Nasal Obstruction and Intermittent Epistaxis

A man in his 20s presented to a tertiary rhinology center in southwestern Florida with a 3-month history of progressive left nasal obstruction and intermittent epistaxis. Two years previously, the man had similar presenting symptoms at an outside facility and was treated with surgery to excise a sinonasal mass. He did not have any visual changes, pain, or purulent nasal discharge. He reported no olfactory impairment. He was originally from Bangladesh but had moved to the United States 6 years earlier. In-office flexible fiberoptic nasal endoscopy revealed a soft, friable polypoid mass with a strawberry-like appearance originating from the lateral nasal wall and filling the left nasal cavity (Figure, A). Computed tomography of the sinuses revealed a left nasal cavity mass without bony destruction or paranasal sinus involvement (Figure, B). The patient underwent endoscopic sinus surgery on the left side, where complete surgical excision of the mass was performed along with electrocautery of attachment sites. The mass was found to have multiple attachments surrounding the maxillary sinus ostium and mucosa overlying the lacrimal bone. Pathologic evaluation revealed squamoid-type mucosa with large, thick-walled sporangia with numerous endospores. Also present was an exuberant mixed inflammatory infiltrate consisting of polymorphonuclear leukocytes, plasma cells, and lymphocytes (Figure, B and C). What is your diagnosis? A B

SAT0166 The Incidences of Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis in Northeastern Part of Turkey.

BackgroundThe epidemiological findings of anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) differ geographically. Until now, there has been no study about the prevalence of AAV in Turkey.ObjectivesIn our study, we aimed to...

Chronic rhinosinusitis in ex-lepromatous leprosy patients with atrophic rhinitis

Rhino-sinus mucosal involvement is well documented in untreated lepromatous leprosy, but less understood in ex-leprosy patients (i.e. leprosy patients who have been treated and cured) with atrophic rhinitis. Rhino-sinus abnormalities were investigated in 13 ex-lepromatous leprosy patients with atrophic rhinitis, using interviews enquiring about sinonasal symptoms, nasal endoscopy, nasal swab culture and computed tomography. Endoscopic sinus surgery had been performed in three patients. The clinical course, computed tomography findings and nasal biopsy results of these three patients were evaluated. All patients had turbinate atrophy and 6 of the 13 (46.2 per cent) had septal perforation. Paranasal sinus involvement was noted in 9 of 12 examined patients (75 per cent). The most commonly affected sinus was the maxillary sinus (in 8 of 12; 66.7 per cent). All three patients treated by endoscopic sinus surgery experienced relapse and required further surgery. Maxillary sinus irrigation was effective for reduction of persistent symptoms such as postnasal discharge and crusts. Ex-lepromatous leprosy patients with atrophic rhinitis had various rhino-sinus abnormalities and persistent symptoms. These patients had chronic rhinosinusitis because of underlying atrophic rhinitis. These patients required repeated otolaryngological observations together with combined surgery and conservative treatment.

Original article Pituitary metastases from the oncocytic variant of follicular thyroid carcinoma: a and diagnostic dilemmas

Metastases to the pituitary gland and sella turcica are uncommon. The distinction between primary and secondary metastatic pituitary tumours is challenging as carcinomas from distant sites might closely resemble, both clinically and histopathologically, non-functional adenomas or primary pituitary carcinomas. Among metastases to pituitary gland ones from thyroid carcinoma are extremely rare. We present a unique case of a 53-year-old male patient with a past history of thyroid carcinoma who underwent repeated surgeries over a period of 7 years for a sellar-parasellar mass with paranasal sinus involvement. Morphologically, the tumour was composed of solid sheaths of monomorphic cells exhibiting oncocytic features. In electron microscope images, the cytoplasm of tumour cells was filled with numerous mitochondria. The tumour was negative for pituitary hormones but exhibited immunoreactivity for cytokeratin AE1/AE3, thyroglobulin and thyroid transcription factor 1 (TTF-1). Based on the clinical data and immunophenotypic profile, the tumour was finally diagnosed as an oncocytic variant of follicular thyroid carcinoma. To our knowledge, this is probably the first report of such peculiar histopathological variant of follicular thyroid carcinoma metastasizing to the pituitary gland. The diagnostic dilemmas considering oncocytic features of the presented case are discussed.

Predictors of central nervous system involvement in diffuse large B-cell lymphoma: a divining rod is wanted

Predictors of central nervous system involvement in diffuse large B-cell lymphoma: a divining rod is wanted

Multiple paranasal sinus involvement from a metastatic follicular carcinoma thyroid

Multiple paranasal sinus involvement from a metastatic follicular carcinoma thyroid

A C1-inhibitor rare mutation: Early diagnosis of hereditary angioedema in a paediatric patient

Hereditary angioedema secondary to C1-inhibitor deficiency is a rare autosomal dominant disorder characterized by a deficiency of C1 esterase inhibitor.An eight-year-old girl showed periorbital painless swelling, diagnosed as ethmoiditis. A craniofacial scan did not evidence a paranasal sinus involvement, C1INH levels were undetectable, with low C4 levels: 7.6 mg/dl and C1INH: <8.46 mg/dl. The genetic study identified a rare mutation of the C1INH gene. This clinical report is of relieve because paediatric cases described in literature are rare, did not presented a positive family history, and received a diagnosis after many attacks. Furthermore our girl received a prompt diagnosis of HAE at the first attack of angioedema.

Prospective Cohort Study with Risk-Adapted Central Nervous System (CNS) Evaluation in Diffuse Large B-Cell Lymphoma Patients Treated with Rituximab-CHOP: Analysis of Incidence and Risk Factors for Secondary CNS Involvement.

Abstract 2683▪▪This icon denotes a clinically relevant abstract BackgroundSecondary central nervous system (CNS) involvement in diffuse large B-cell lymphoma (DLBCL) includes CNS relapse or CNS involvement with systemic disease progression. Although many publications have provided information regarding the incidence and risk factors for CNS involvement in DLBCL, its incidence reported across those studies varies widely. It might be related with that the majority of data were from retrospective analyses. Furthermore, the role of CNS prophylaxis for DLBCL has been challenged, especially in the era of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). As a result, this rare but fatal clinical problem still remains a therapeutic dilemma in the management of DLBCL. In this study, we prospectively explored the risk factors of CNS involvement and the clinical impact of screening evaluation for CNS involvement. MethodsWe analyzed the incidence of secondary CNS involvement in pathologically confirmed DLBCL patients enrolled in the Prospective Cohort Study with Risk-adapted Central Nervous System Evaluation in Diffuse Large B-cell Lymphoma (PROCESS study, NCT01202448). Patients should be treated with at least one cycle of R-CHOP, and provide written informed consents. We assessed the risk of CNS involvement based on previously reported risk factors: serum LDH elevation, the number of extranodal involvements, serum albumin, bone marrow invasion, HIV positivity, the involvement of testis, breast, paranasal sinus, bone, retroperitoneal lymph nodes, orbit, and epidural space. If patients had any of these risk factors, they underwent CSF study to screen the CNS involvement at diagnosis. If the results were abnormal, additional studies including brain MRI could be done depending on physicians' decision. CNS prophylaxis was done with intrathecal chemotherapy with methotrexate for patients who had positive findings of screening evaluation or were determined to have a risk of CNS involvement based on physicians' decision. Results564 patients were enrolled between 2010 and 2012 from 26 institutions belonged to the Consortium for Improving Survival of Lymphoma (CISL). They were prospectively monitored with the median follow-up duration of 10.5 months. The median age was 59.5 years old (range 20–89 years), and approximately a half of patients had Ann Arbor stage III/IV (n = 276, 48.9%) and 193 patients involved two or more than two extranodal sites (34.2%). Based on the International Prognostic Index (IPI) risk, 192 patients belonged to high or high-intermediate risk (34%). Among patients (n = 368) who had at least one of risk factors for CNS involvement, 243 patients underwent CNS evaluation, and the evidence of CNS involvement was found in16 patients including positive cytology (n = 11), and brain parenchyma lesion (n = 5). The other 78 patients showed equivocal results of CSF analysis including the presence of atypical cells (n = 17). Intrathecal prophylaxis was done for 51 patients whereas high dose methotrexate chemotherapy was combined with R-CHOP for patients with brain lesion. During follow-up, 14 cases of additional CNS involvement including brain parenchyma (n = 8), leptomeningeal (n = 5), and ocular invasion (n = 1) were observed. The median time to CNS event in these 14 patients was 7.5 months (range 1.2 – 15.9 months). Thus, 30 cases of secondary CNS involvement were documented in our study population at the time of analysis (5.3%) including 16 cases at diagnosis and 14 cases during follow-up. The univariate analysis for evaluation of risk factors demonstrated serum LDH, the number of extranodal involvements, bone marrow invasion, and the involvement of retroperitoneal lymph nodes, breast, paranasal sinus and orbit were significantly associated with CNS involvement. The high/high-intermediate risk of IPI was also predictive of CNS involvement (P < 0.05). However, in the multivariate analysis, bone marrow invasion and the involvement of breast, paranasal sinus and orbit were independently predictive for CNS involvement. ConclusionsThe incidence of secondary CNS involvement in DLBCL patients treated with R-CHOP was around 5%, and a half of cases had the evidence of CNS involvement at diagnosis. Considering a particular risk of CNS involvement of disease-related factors, risk-adapted active screening against CNS involvement may help to improve treatment outcome of patients with DLBCL. Disclosures:No relevant conflicts of interest to declare.

Central Nervous System Aspergillosis

Central nervous system (CNS) aspergillosis is a highly fatal infection. We review the clinical presentation, diagnosis, and outcome of this infection and present a case series of 14 consecutive patients with CNS aspergillosis admitted to Massachusetts General Hospital (MGH) from 2000 to 2011. We also review 123 cases reported in the literature during that time. We included only proven CNS aspergillosis cases conforming to the European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) definitions of invasive fungal infections. In the MGH case series, neutropenia, hematologic malignancies, autoimmune diseases requiring steroid treatment, and solid organ transplantation were the predominant comorbid conditions. Notably, all MGH patients were immunosuppressed, and more than half (n = 8) had a history of previous brain injury, unrelated to their index hospitalization. For most MGH patients (11 of 14), the lung was the primary focus of aspergillosis, while 2 had paranasal sinus involvement, and 1 had primary Aspergillus discitis. Among reported cases, paranasal sinuses (27.6%) and the lung (26.8%) were the primary foci of infection, whereas 22% of those cases had no obvious primary organ involvement. Although a selection bias should be considered, especially among published cases, our findings suggest that patients who underwent neurosurgery had improved survival, with MGH and literature patients having 25% and 28.6% mortality, respectively, compared to 100% and 60.4%, respectively, among patients who received only medical treatment. Although this was not the case among MGH patients, CNS aspergillosis can affect patients without significant immune suppression, as indicated by the high number of reported immunocompetent cases. In conclusion, mortality among CNS aspergillosis patients remains high, and the infection may be more common among patients with previous brain pathology. When indicated, neurosurgical procedures may improve prognosis.

Results of computed tomography in horses with ethmoid hematoma: 16 cases (1993–2005)

To determine whether CT provides unique information about the treatment or prognosis for horses with ethmoid hematoma (EH). Retrospective case series. 16 horses with EH. Horses with a diagnosis of EH that had undergone a diagnostic CT study were included. Clinical features, treatment, outcome, radiographic and CT images, and histologic specimens were reviewed. CT provided new diagnostic information that affected treatment in 10 of 16 horses. Bilateral disease occurred in 8 of 16 horses and was undetected in 5 horses prior to CT. Paranasal sinus involvement occurred in all horses, but was incompletely defined prior to CT in 7 of 16 horses. The sphenopalatine sinus was affected in 6 of 16 horses as detected on CT; 4 of 6 of these were bilaterally affected. Medical and surgical treatments were performed. Six of 10 horses had a successful outcome, with recurrence in 4 of 10. Five of 6 patients in which treatment addressed all lesion sites identified by CT had a successful outcome. Bilateral disease did not confer a poor prognosis when all affected sites were treated. Sphenopalatine sinus involvement may have been associated with recurrence. CT provided anatomic information that may facilitate effective treatment of horses with EH, particularly in patients with bilateral disease and paranasal sinus involvement. Computed tomography is recommended for patients in which the lesion cannot be viewed endoscopically, when sinus involvement or multifocal disease are suspected, or when the lesion has been unresponsive to treatment.

Olfactory groove meningioma: Discussion of clinical presentation and surgical outcomes following excision via the subcranial approach

To describe surgical outcomes and radiographic features of olfactory groove meningiomas treated by excision through the subcranial approach. Special emphasis is placed on paranasal sinus and orbit involvement. Retrospective review of a series of patients. Nineteen patients underwent excision of olfactory groove meningioma (OGM) via the transglabellar/subcranial approach between December 1995 and November 2009. Nine patients had previously undergone prior resection at outside institutions, and four had prior radiotherapy in addition to a prior excision. Transglabellar/subcranial surgical approach to the anterior skull base was performed. Tumor histology included three World Health Organization (WHO) grade III lesions, one WHO grade II lesion, and 15 WHO grade I lesions. Fourteen patients had evidence of extension into the paranasal sinuses, with the ethmoid sinus being most commonly involved. Kaplan-Meier estimates of mean overall and disease-free survival were 121.45 months and 93.03 months, respectively. The mean follow-up interval was 41.0 months, and at the time of data analysis three patients had recurrent tumors. Seven (36.8%) patients experienced a major complication in the perioperative period; there were no perioperative mortalities. Orbit invasion was observed in four patients, with optic nerve impingement in 11 patients. Of these, three patients had long-term diplopia. No patients experienced worsening of preoperative visual acuity. Olfactory groove meningiomas demonstrate a propensity to spread into the paranasal sinuses, particularly in recurrent cases. Given a tendency for infiltrative recurrence along the skull base, this disease represents an important area of collaboration between neurosurgery and otolaryngology. The subcranial approach offers excellent surgical access for excision, particularly for recurrences that involve the paranasal sinuses and optic apparatus.

Fibrous dysplasia of the frontal sinus: a case report

Fibrous dysplasia is a rare and indolent benign tumor of bone. Although it is a benign tumor, it has malignant transformation potential. Fibrous dysplasia can involve a single or multiple bones. The maxilla and mandible are the most common sites in the head and neck region. Paranasal sinus involvement is rare. Surgical excision is the preferred treatment of patients with symptomatic fibrous dysplasia. In this article, a 54-year-old male patient diagnosed with fibrous dysplasia of the frontal bone is presented.