Giant ethmoid osteoma originated from the lamina papyracea

Giant fronto-ethmoidal osteoma - selection of an optimal surgical procedure

Introduction

Osteomas of the paranasal sinuses are benign bone tumours that produce clinical signs depending on their size and location. In most reported cases large tumours are excised by an external approach or in conjunction with an endoscopic technique. Endoscopic treatment of such tumours is a huge challenge for the operator.

Objective

Determine the optimal surgical approach by analysing giant osteomas of the frontal and ethmoidal sinuses in the literature.

Methods

Group of 37 osteomas obtained from the literature review. A group of osteomas removed only by endoscopy was compared with a group in which an external approach (lateral rhynotomy or craniotomy) or combined external and endoscopic approach was applied.

Results

The authors, based on the statistical analysis of the literature data, have found that the average size of osteomas excised endoscopically and those removed by external approaches does not differ statistically, when the osteomas are located in the ethmoidal cells (p = 0.2691) and the frontal sinuses (p = 0.5891).

Conclusion

The choice of surgical method appears to be independent of the osteoma size and the decision is likely to be taken based on the experience of the surgeon, available equipment and knowledge of different surgical techniques.

[Endoscopic endonasal surgery of paranasal sinus osteomas]

This article was designed to summarize the experience gained withendoscopic endonasal removal of paranasal sinus osteomas during the period from January 2013 till February 2016. In addition a review of the relevant literature is presented encompassing the publicationsthat provide information about etiology, pathogenesis, clinical picture, diagnostics, and treatment of bone tumours. The objective of the study was to enhance the effectiveness and safety of the surgical treatment of the patients presenting with paranasal sinus osteomas. A total of 81 cases of paranasal sinus osteoma were documented in the patients admitted to I.P. Pavlov Saint-Peterburg First State Medical Universityduring the period from January 2013 till February 2016. Forty nine of them were given the surgical endoscopic endonasal treatment with the removal of the neoplasm. The remaining 32 patients were included in the group for the further dynamic follow up. The authors report the data of morphological studies and the results of computed tomography performed in the pre- and postoperative periods with special reference to the potential for the use of the electromagnetic navigation station (an image-guidance system) that makes it possible to significantly reduce the risk of development of possible complications. In addition, the findings suggestive of the progressive tumour growth in the group of the patients under dynamic observation are discussed.