Paranasal Sinus Osteomas Research Articles

Exploring the age and gender-based distribution of paranasal sinus osteomas using cone beam computed tomography: A retrospective cross-sectional study

ObjectiveThe objective of this study is to explore the prevalence, size, location and radiographic features of osteomas in the paranasal sinuses using cone beam computed tomography imaging. Study designThis study was planned as retrospective cross-sectional. 499 consecutive cone beam computed tomography scans obtained in a dentomaxillofacial radiology department for various dental indications. Statistical analysis of all data was done with SPSS version 22. Descriptive statistics and chi-square tests were used to determine the prevalence of categorical parameters. ResultsOsteoma was detected in 7 % (n = 35) of the 499 images analyzed. The age of the patients ranged from 6 to 96 years (mean 42.03 ± 18.70). No significant difference was found between the genders (p = 0.77). In terms of localization, it was significantly more common in the ethmoid sinuses (p < 0.01). Cortical type osteoma was observed the most frequently in the analyzed images (p < 0.01). The incidence of osteoma was not significant depending on age (p = 0.50). ConclusionOsteomas in the paranasal sinuses show a 7 % prevalence in CBCT images, with the ethmoid sinus being the most common site. The average size of osteomas was 3.43 ± 1.78 mm, predominantly cortical in type. These findings highlight the necessity for thorough examination of CBCT images by dentomaxillofacial radiologists to avoid overlooking osteomas.

Growth rate, impact of smoking and management of incidentally found paranasal sinus osteomas

ObjectiveTo build upon existing literature regarding growth rate of asymptomatic, incidentally found paranasal sinus (PNS) osteomas, evaluate potential factors associated with growth rate and present an argument for how to follow up. MethodsAt our institution, EPIC SlicerDicer was used to screen imaging studies using keyword ‘osteoma’ and included patients with at least 2 imaging studies 6 months apart that both demonstrated a PNS osteoma(s). Imaging studies with the largest time interval were selected. Non-PNS osteomas were excluded. Results47 patients that fit this criterion with a median duration of interval imaging of 35.9 months. Growth rate was measured to be 0.39 mm/year in the cephalocaudal direction and 0.45 mm/year in the mediolateral direction, together averaging 0.42 mm/year. Increases in growth rate additionally did not appear to impact the likelihood of developing conditions including nasal polyposis or chronic sinusitis and symptoms such as sinus pressure, headache, postnasal drip, or congestion. Those with interval scans >36 months were found to have a slower growth rate than those with closer interval scans. Furthermore, former smokers and current smokers had significantly greater growth rates than nonsmokers. ConclusionGiven their slow growth rate, we conclude that select lesions likely do not require follow-up. If there is concern that growth could cause an obstructive complication, such as blocking the frontal outflow tract, we argue a single scan at one year is appropriate. If there is additional growth on this scan, surveillance scans up to 3 years could be performed to assess stability. Lastly, while there was a significant growth rate for smokers compared to non-smokers, the slow growth rate is unlikely to influence management.

Multicompartmental Paranasal Sinus Osteoma Complicated by Frontal Bone Hyperostosis, Intracranial Mucocele, and Inflammatory Pseudotumor

Parasinusal osteoma complicated by intracranial and orbit extension, cranial vault hyperostosis, intracranial mucocele and inflammatory pseudotumor is exceptional. A 68-year-old man complaining a long history of progressive proptosis and recurrent episodes of keratoconjunctivitis of the left eye, with restriction in upward gaze, was observed. Contrast-enhanced magnetic resonance imaging revealed a frontal sinus lesion extending to the left anterior fossa and orbit, featuring intracranial cystic component and heterogeneous contrast-enhancement. Head computed tomography confirmed the double calcific-cystic nature of the lesion. A left supraorbital-pterional approach allowed the complete resection of mucocele and drilling of intracranial and orbital osteoma, including the intra-sinusal component. The frontal sinus was cranialized and a flap of pericranium, reinforced by Gelfoam sponge, was reflected on the anterior cranial base/orbital roof. The postoperative course was uneventful; MRI depicted resolution of the proptosis. The histologic examination was in favor of parasinusal osteoma associated to intracranial mucocele, frontal bone hyperostosis and inflammatory pseudotumor.

A Giant Frontoethmoidal Sinus Osteoma Presenting With Frequent Sleep Apnea Attacks: A Case Report

Background: Paranasal sinus osteomas are benign, slow-growing tumors that are typically asymptomatic. However, in rare cases, these tumors can grow to a giant size and extend into neighboring structures such as the brain, orbit, or nasal cavity, leading to clinical symptoms. These symptoms may include chronic headaches, rhinorrhea, neurological deficits, and visual impairment. Case presentation: Here, we present the case of a 27-year-old male patient who presented to our hospital with chronic headaches and frequent sleep apnea. Upon rhinoscopic examination, mucosal polyposis was observed. Further evaluation through computed tomography revealed a giant fibroosseous tumor in the frontal sinus, which exhibited aggressive extension into the brain parenchyma. Contrast-enhanced magnetic resonance imaging confirmed the presence of a giant tumor with an 8 cm diameter, exerting a mass effect on the underlying brain tissue. To address this complex case, the patient underwent a combined transcranial and transnasal surgical approach. Following the surgery, the patient experienced significant improvement in his symptoms. Conclusions: This report highlights a rare case of sleep apnea secondary to a giant frontoethmoidal osteoma with intracranial extension. The presence of frontal sinus osteomas can lead to serious clinical consequences. Timely diagnosis and intervention are crucial to prevent intracranial extension and mitigate potential complications associated with these lesions.

Endoscopic Excision of Rare Large Maxillary Sinus Osteoma: A Case Report and Literature Review

Paranasal sinus osteomas are the most common benign fibro-osseous lesions that occur in the paranasal sinuses, having potential serious complications. With a prevalence ratio of 2:1 towards males, in 95% of the cases, the osteomas are situated most commonly in the frontoethmoidal region. However, osteomas of the maxillary sinus account for less than 5% of cases. The management of symptomatic paranasal sinus osteomas is surgical and is decided based on tumor size and location, patient symptoms, and experience of the surgeon. The Caldwell–Luc procedure, lateral rhinotomy, or craniotomy as external standard procedures remain mandatory if endonasal endoscopic surgery fails. In most reported cases, large tumors are excised by an external approach or in conjunction with an endoscopic technique. Endoscopic treatment of such tumors is a huge challenge for the operator. We report on a 42-year-old male patient presenting with a giant calcified mass in the right maxillary sinus. In this case, an endonasal approach was the most appropriate management even with the large size of the tumor. No recurrence at 24 months follow-up was reported.

Fronto-Ethmoidal Osteoma with Orbital Extension: Which Approach?

Paranasal sinus osteoma is a rare benign tumor that evolves slowly and can be responsible for ophthalmologic, sinus and endocranial complications. Its treatment, when it is necessary, is only surgical. We report two cases of fronto-ethmoidal osteoma with orbital extension operated in our department, using a para-latero-nasal approach with supra-superciliary extension. Through these cases and in the light of the literature, we will discuss the interest of this approach in the management of ethmoidal fronto-orbital osteomas. Also, we will underline the advantages and inconveniences of other approaches.

Clinical Manifestations and Surgical Treatment Outcomes of Paranasal Sinus Osteoma

Background and Objectives: Osteomas are the most common benign tumors of the nasal cavity and paranasal sinuses (PNSs). In this study, clinical features and imaging findings were analyzed in patients with osteoma confirmed by ostiomeatal unit (OMU) computed tomography (CT) and PNS CT, and the surgical treatment performed at our hospital was introduced.Methods: The Severance Clinical Research Analysis Portal (SCRAP) service of Severance Hospital was used to collect research data. A total of 128 cases of osteomas of the nasal cavity or PNSs confirmed by OMU CT or PNS CT was retrospectively reviewed, including the location and size of the osteoma, clinical features, accompanying findings on imaging tests, and cases of surgical treatment.Results: In this study, osteomas were found in about 0.55% of patients who underwent computed tomography. Osteomas were most frequently found in the ethmoid sinus, followed by the frontal sinus, fronto-ethmoid sinus, maxillary sinus, intranasal sphenoid sinus, and maxillary sinus-ethmoid sinus. Patients with osteomas complained of symptoms such as rhinorrhea, postnasal drip, nasal congestion, hyposmia, headache, visual disturbance, and lacrimal duct obstruction.Conclusion: Surgical treatment was considered for patients presenting with severe headache, visual field symptoms, or accompanying rhinosinusitis. Surgery was performed by endoscopic or external approaches depending on location and size of the osteoma.

Surgical Approach to Paranasal Sinus Osteomas: Our Experience in 22 Cases

Surgical Approach to Paranasal Sinus Osteomas: Our Experience in 22 Cases

Paranasal Sinus Osteomas: Evaluation of Surgical Management with 13 Cases

Paranasal Sinus Osteomas: Evaluation of Surgical Management with 13 Cases

Surgical Approach to Paranasal Sinus Osteomas: Our Experience in 22 Cases

Surgical Approach to Paranasal Sinus Osteomas: Our Experience in 22 Cases

Surgical Approach to Paranasal Sinus Osteomas: Our Experience in 22 Cases

Objective: Paranasal sinus (PNS) osteomas are rare, but the most common benign bone tumors of the paranasal region that can remain asymptomatic until reaching certain size are usually diagnosed incidentally. This study aimed to evaluate the factors that determine the surgical approach to PNS osteomas. Methods: This retrospective study included 22 patients who underwent surgery for PNS osteoma between January 2012 and December 2018. Demographic characteristics, tumor location and size, symptoms, surgical techniques, and postoperative complications were analyzed retrospectively. The relationship between the location and size of the osteoma and the surgical approach was investigated. Results: Of the 22 patients who underwent surgery for PNS osteoma, eight (36.3%) and 14 (63.7%) were women and men, respectively. The mean age of the patients was 39.1 years (range, 21–54 years). Based on their PNS location, osteomas were found in the ethmoid, frontal, maxillary, and both frontal and ethmoid sinuses in 10 patients (45.4%), eight patients (36.3%), three patients (13.6%), and one (4.5%) patient, respectively. The tumor was excised using the osteoplastic flap technique in five (22.7%) patients with frontal sinus osteomas larger than 2 cm in size. A combination of the Caldwell–Luc and transnasal endoscopic techniques was used in three (13.6%) patients with maxillary sinus osteomas. The tumor was excised using the lateral rhinotomy technique in one patient (4.5%) with a giant osteoma in the ethmoid sinus. Osteoma excision was performed using a transnasal endoscopic approach in the remaining 12 patients with ethmoid (n ¼ 9) and frontal sinus (n ¼ 3) involvement. Conclusions: Although the tendency to perform minimally invasive and less morbid transnasal endoscopic approaches in PNS osteoma surgery is increasing, open surgical techniques and combined approaches should be preferred for ethmoid and frontal sinus osteomas with potential complications and which extend beyond the PNS boundaries. PNS osteoma size and localization, surgical equipment, endoscopic sinus surgery experience, and experience in open surgical techniques are the determinants for the surgical approach in PNS osteoma surgery. Keywords: Osteoma, osteoplastic flap, paranasal sinus, transnasal endoscopic approach

Evaluation of the Association between Paranasal Sinus Osteomas and Anatomic Variations Using Computed Tomography

Evaluation of the Association between Paranasal Sinus Osteomas and Anatomic Variations Using Computed Tomography

Evaluation of the Association between Paranasal Sinus Osteomas and Anatomic Variations Using Computed Tomography

Objective:The pathogenesis of paranasal sinus osteoma (PSO) has not been fully elucidated. It is thought that both embryological and developmental factors play a role in the etiology. The aim of the present study was to investigate the association of frequency and localization of PSOs detected on computed tomography (CT) examination with osteoma presence.Methods:In this retrospective study conducted in December 2017 through March 2020 in Gaziosmanpaşa University Faculty of Medicine, images of a total of 18,867 patients who underwent paranasal sinus, maxillofacial CT and brain CT angiography were reviewed for the presence of PSOs. Sizes of PSOs and accompanying mucosal pathologies were identified. Associations between PSOs and paranasal sinus variations were evaluated statistically compared to the control group (200 patients without PSO).Results:A total of 176 patients (0.92%) were found to have PSO. Average age of the patients with PSO was 59.9 years (range: 18–93). PSOs were unilateral in 152 patients while 24 patients had multiple osteomas. Female/male ratio was 1.1/1. PSOs were most commonly located in the frontal sinuses. Frequencies of vertical concha bullosa, secondary middle turbinate, twisted uncinate, supraorbital ethmoid cell, intersinus septal cell, ethmoidomaxillary cell, Haller’s cell, frontal sinus hypoplasia and sphenoid sinus hypoplasia were significantly higher in the patient group compared to the control group.Conclusion:Higher or lower incidence rates of some anatomic variations in the patients with PSO could be explained by the possible effects of genetic and/or environmental factor. Additional studies are needed to evaluate these possible associations.

Gigantic paranasal sinuses osteomas: clinical features, management considerations, and long-term outcomes.

Paranasal sinus osteomas are slow-growing, benign bony tumours that when larger than 30mm, they are termed 'gigantic'. Special considerations apply for tumours of this calibre, and their rarity renders their management fairly controversial. This study seeks to contribute to an increased understanding concerning their management by presenting a 12-year experience from a single institution. Retrospective review of files of patients treated for a gigantic paranasal sinus osteoma from January 2008 to December 2019. Additionally, all patients were prospectively reexamined in early 2020 for late complications or clinical recurrence. Ten patients were included, with a mean age of 53.8years (range: 23-77years). The leading presenting findings were proptosis (80%) and diplopia (70%). Transient visual impairment was remarkably frequent (30%). Five patients were managed with an open approach, two with an endoscopic, and three with a combined technique. The most common adverse characteristics that dictated the use of an open approach, alone or in combination with an endoscopic approach, were the involvement of the anterior wall of the frontal sinus (40%), erosion of its posterior wall (30%), and a far-anterior intraorbital extension (30%). No major postoperative complications were observed, and also no recurrences. Our study illustrates that these tumours may require a different management attitude. Despite substantial advances in the endoscopic management of benign sinonasal tumours, managing these massive tumours solely endoscopically could, in many cases, be inefficacious or impossible. Open approaches remain valuable, representing a safe and straightforward method for adequate exposure.

Orbital Emphysema Secondary to Frontal Osteoma.

Repeated bouts of nose blowing can at times lead to orbital emphysema due to stress fracture in the medial or the inferior wall of the orbit. Very rarely, this can result from paranasal sinus osteoma rendering the orbital wall weak. We report only the fifth case of literature to have such an association. Also, we managed our case non-surgically, as against the previous reports treated surgically. In discussion, we highlight the nuances related to principles of management, including the role of computed tomography, and surgical intervention.

Case study of giant frontal-ethmoid sinus osteoma

Aim: The authors hereby present a case of giant frontal-ethmoid sinus osteoma which is not so rare but in the present case, the size and orbital involvement of this tumor make it a unique case. Introduction: Paranasal sinus osteoma most commonly presents in frontal sinuses. Their growth is slow, and patients usually seek physician’s advice only for cosmetic reasons. Case Description: A 20-year-old female presented to us with the complaint of proptosis of left eye near medial canthus for last 6 months. After investigations, she was diagnosed with frontal-ethmoid sinus osteoma, which was excised by endoscopic approach. There was dense, compact bone and broad trabeculae of mature bone i.e. compact osteoma which was confirmed on histopathology. Conclusion: Paranasal sinus osteomas are slow-growing bony tumors, which are amenable to complete cure provided adequate preoperative planning and conscientious surgical technique is used.

Paranasal Sinus Osteomas: Surgical Outcomes at a Single Institution

Paranasal Sinus Osteomas: Surgical Outcomes at a Single Institution

Surgical Approach to Paranasal Sinus Osteomas: Our Experience in 22 Cases

Surgical Approach to Paranasal Sinus Osteomas: Our Experience in 22 Cases

Is there any association between Nasal Polyposis and Osteoma? A retrospective analysis of incidence of Paranasal Sinus Osteoma among 600 patients treated for Nasal Polyposis

Osteoma is a rare benign lesion of the skull, with an incidence of 0.6% of all benign tumours of paranasal sinuses. It is commonly asymptomatic, and mostly diagnosed incidentally at the imaging. The most frequent disturbs are: headache, nasal discharge and symptoms of inflammation. Osteoma is often associated with nasal polyposis and mucocele, which are usually considered as secondary lesions. Contrariwise, in our cases, we are prone to consider the osteoma as secondary to the inflammation associated with polyposis and mucocele. The physiopathology of these diseases was therefore reviewed to explain a possible relationship. We conducted a retrospective analysis in our ENT division from January 2010 to December 2016.

Frontal recess osteoma causing severe headache

Frontal sinus osteomas are benign and well-defined masses that may cause various symptoms when they press on the surrounding tissues. Paranasal sinus osteoma is seen as a well-defined mass showing high opacity in Computed tomography. In this case study, we presented here a 53-year-old frontal recess osteoma with severe headache filling the left frontal recess in the context of the literature.