Diagnosis of frontal osteoma is usually by chance, but rarely these can produce exceptional ophthalmologic and neurological complications apart from cosmetic disfigurement. Etiology of frontal osteoma may be multifactorial. Surgical management should be site and size specific. A combination of open surgery and endoscopic methods would help confirm complete removal of the tumor. Here we report a fronto-ethmoidal osteoma of size 7.1 × 5.3 × 5.1 cm which is one of the largest reported in literature. Also, we have done an extensive web search and text based review of the literature on frontal osteoma in terms of its incidence, etiology, pathology, clinical presentation, complications and important developments in management. The available literature and our own experience suggest that even large osteoma arising in the fronto-ethmoid region can be completely removed surgically with minimum complications. The surgical approach can be varied according to the extent of the tumor and patient considerations. A regular follow up is necessary in asymptomatic cases being treated conservatively, in view of the potential complications.
Incidence of discharge, debris, giddiness, pain was reduced in obliterated cavities. Healing of cavity was better in obliterated ears. Cavity obliterated with bone dust and flap had better and early epithelialisation as compared to cartilage.
Wegeners granulomatosis is a necrotizing granulomatous vasculitis with multisystemic involvement. We present two cases of Wegener's presenting with otological manifestations as the first symptom. These symptoms are subtle and diagnosis may be easily overlooked. Hence a high index of suspicion is required. Early diagnosis and treatment goes a long way in improving the outcomes and in preventing further complications.
Ameloblastomas are rare, slowly growing and locally invasive tumours with high recurrence rate, if not treated they can grow to enormous size; we report five such cases in our article and discuss their surgical management. We report five cases of giant ameloblastoma presented in our institute between 2007 and 2010, we treated them surgically with wide margin of resection. It is widely reported that recurrence of ameloblastoma in many cases reflects the inadequacy or failure of the primary surgical procedure. We treated all our cases with radical excision with free flap reconstruction with no recurrence in any of our patients in 2 years follow-up. Radical excision of these benign but locally invasive lesions, which grows to giant size with reconstruction using micro vascular free flaps forms the best modality of treatment.
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