Fibro-osseous lesions of the paranasal sinuses and the skull base

Abstract

<p class="abstract"><strong>Background:</strong> Osteomas, ossifying fibromas, and fibrous dysplasia comprise a set of benign neoplasms known as fibro-osseous lesions (FO), which can arise in the paranasal sinuses. The vast majority of benign FO lesions (BFOL) are incidental findings on radiographs. They tend to be slow-growing tumors, and are infrequently symptomatic. The management strategy can vary significantly for theses lesions. This can range from serial, observations to aggressive surgical resection, based on symptomatology, size, and location of the lesion.</p><p class="abstract"><strong>Methods:</strong> Retrospective analysis of all the data of different symptomatic FO of the paranasal sinuses and the skull base was performed at King Fahad specialist hospital, Dammam, KSA (2006 to 2017). </p><p class="abstract"><strong>Results:</strong> A total of 21 patients were identified; 10 (46.7%) patients were diagnosed with osteoma, 8 (38.1%) with fibrous dysplasia, 2 (9.5%) with ossifying fibroma and one (4.8%) with juvenile active ossifying (JAOF), 17 were adults and 4 were children, the range of f/u (3-60) months. 19 patients were managed by the endonasal endoscopic approach. They continue to be followed with no evidence of recurrence. Two cases required the revision combined endoscopic open approach to ensure adequate removal of the disease (residual and recurrence).</p><p><strong>Conclusions:</strong> Diagnostic dilemma of BFOL can be overcome with a combination of clinical, radiological and pathological criteria. Correct diagnosis of fibro-osseous tumors is crucial for adequate therapy as their treatment, prognosis, clinical aggressiveness and long term complications of individual entities vary significantly. Endoscopic computer-assisted surgery is the treatment of choice. Endoscopic resection remains a technical challenge. </p>

Intractable Trigeminal Neuralgia Secondary to Osteoma of the Clivus: A Case Report and Literature Review

“…ESS or open surgery's decision mainly depends on the site and the tumor's size and the surgeon's preference. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] In our case, the aim was to decompress the trigeminal nerve. Hence, open surgery was decided on through a retrosigmoid approach.…”

“…Osteomas are made up of dense, mature bone, and exhibit benign features. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 They mostly arise from the calvarium and the mandible. 1 2 3 4 Skull base osteomas (SBOs) are relatively rare; however, they are considered the most commonly benign, paranasal sinus tumors with a point incidence of 0.4 to 1% of the general population.…”

“…1 2 5 6 7 8 9 10 11 Osteomas are more common in males, with a male-to-female ratio of 1.5 to 3:1. 1 2 4 6 7 8 9 10 13 SBO is most commonly found involving the anterior skull base in or around the sinonasal cavities. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 However, osteoma may arise from the middle and posterior skull base.…”

“…1 2 4 6 7 8 9 10 13 SBO is most commonly found involving the anterior skull base in or around the sinonasal cavities. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 However, osteoma may arise from the middle and posterior skull base. 11 14 16 18 20 Clival osteoma is extremely rare and has not been reported yet.…”

Fibro-Osseous Lesion of the Nose and Paranasal Sinus: A Retrospective Study With Literature Review

“…On the other hand, a slowly progressive lesion often does not require extensive surgical excision. Alturaiki et al review all cases of fibro-osseous lesions in the nose and paranasal sinuses [16]. They found that osteomas were found at the frontal sinuses in 40% of cases (four patients), sphenoid sinus in 20% (two patients); other two cases were found in the frontoethmoidal area, and one case involved the ethmoid sinus (10%).…”