Surgical Treatment of Paranasal Sinus Osteomas: A Single Center Experience of 58 Cases

Abstract

ObjectivesOsteomas are osseous tumors that primarily occur at the skull, in particular the paranasal sinus system. Surgical tumor resection is the “gold standard” treatment in symptomatic osteomas. The aim of this study was to investigate the use of surgical approaches (endoscopic, open, combined) and to provide a step‐by‐step approach for patients’ management.MethodsFifty‐eight patients (31 m, 27 f, 42.1 ± 15.3 years) that were treated between 2001 and 2015 at our department were included in this retrospective, single center study.ResultsIn almost half of cases (n = 28, 48.3%) endoscopic, endonasal approaches were used for tumor resection while open (n = 11, 19%) or combined (n = 19, 32.8%) approaches were used in the rest of the cohort. Open or combined approaches were applied in patients suffering from osteomas localized in the maxillary or frontal sinuses only.ConclusionBeside interviews, clinical examination, nasal endoscopy, and computed tomography are crucial for diagnosis of paranasal sinus osteomas. Magnet resonance imaging can be useful in extensive pathologies. The preoperative selection of the optimal approach for osteoma resection might be most challenging in patients’ management. Although useful recommendations regarding the use of surgical approaches have been published, technical requirements and surgical experience of surgeons have to be considered in the limitations of endoscopic approaches. If there are doubts about the resectability of an osteoma by an endoscopic approach, the surgical procedure may be started endoscopically, and, if necessary, it can be combined with an external approach.Level of EvidenceIV Laryngoscope, 130:2105–2113, 2020

Fibro‐osseous Lesions of Paranasal Sinus and Craniofacial Region: A Retrospective Study of 282 Cases

“…In this study, 10.6% of patients were in such a case, which, to some extent, explained why osteoma is treated at a later age than OF and FD. In this group of osteoma patients, the incidence rate in females was about twice of that in males, which is different from high recurrence rate in males reported in previous studies 12–14 . It might be caused by the difference in the cases included in the study.…”

“…In this group of osteoma patients, the incidence rate in females was about twice of that in males, which is different from high recurrence rate in males reported in previous studies. [12][13][14] It might be caused by the difference in the cases included in the study. For osteoma in the frontal sinus, studies have proposed different grading systems to develop surgical protocols.…”

Seltene Erkrankungen der Nase, der Nasennebenhöhlen und der vorderen Schädelbasis

“…Druckgefühl, Gesichtsschmerzen und Rhinorrhoe sind klassische Symptome. Bei Beteiligung benachbarter Strukturen der Nasennebenhöhlen kann es zu Kompressionen der Orbita oder des Nervus opticus sowie bei intrakranieller Beteiligung zu einem Pneumatocephalon kommen [158,161].…”

“…Die vollständige chirurgische Exzision ist Therapie der Wahl, auch wenn Rezidivraten von bis zu 30 % berichtet werden. Bei Meningeomen, die nicht vollständig resektabel sind, kann eine Radiotherapie zur Wachstumshemmung führen [156,157] [118,158,160].…”

“…The etiology of the tumors is not fully clarified. Current theories assume embryonic malformations, traumatic or inflammatory triggers, genetic predisposition, and disorders of the calcium metabolism as origin of the disease 118 158 160 .…”