Abstract
Osteomas are among the most common benign tumors of the paranasal sinuses. Symptomatic osteomas are most often found in the frontal recess and the frontal sinus. While the extranasal approach is still a part of the treatment concept for removing osteomas at this localization, over the last years the endoscopically controlled endonasal approach has greatly gained in importance due to the improved surgical equipment. We retrospectively analyzed the surgical indication, surgical approach and outcome of the removal of osteomas of the frontal recess and the frontal sinus performed at our hospital between 1996 and 2010. The exact surgical technique, intra- and postoperative complications, the duration of the hospital stay and the follow-up and subjective contentment of the patients were evaluated. With a total of 24 patients being included, the study comprises one of the largest groups of patients with osteomas of the frontal recess and sinus. Over the study period, the frequency of the endoscopic approach clearly increased. Previously suggested guidelines for the endoscopic resection of a frontal sinus osteoma turned out to be superseded. Endoscopically controlled resection even of large, adversely located osteomas of the frontal recess and the frontal sinus is becoming increasingly possible, but is still naturally limited by the individual anatomic conditions and the need for experienced surgeons.
Similar content being viewed by others
References
Al-Sebeih K, Desrosiers M (1998) Bifrontal endoscopic resection of frontal sinus osteoma. Laryngoscope 108:295–298
Larrea-Oyarbide N, Valmaseda-Castellon E, Berini-Aytes L, Gay-Escoda C (2008) Osteomas of the craniofacial region. Review of 106 cases. J Oral Pathol Med 37:38–42
Seiberling K, Floreani S, Robinson S, Wormald PJ (2009) Endoscopic management of frontal sinus osteomas revisited. Am J Rhinol Allergy 23:331–336
Lund VJ, Stammberger H, Nicolai P, Castelnuovo P, Beal T et al (2010) European position paper on endoscopic management of tumours of the nose, paranasal sinuses and skull base. Rhinol Suppl 22:1–143
Eckel W, Palm D (1959) Statistical and roentgenological studies on some problems of osteoma of the paranasal sinuses. Arch Ohren Nasen Kehlkopfheilkd 174:440–457
Schick B, Steigerwald C, el Tahan A, Draf W (2001) The role of endonasal surgery in the management of frontoethmoidal osteomas. Rhinology 39:66–70
Sudhoff H, Theegarten D, Luckhaupt H (2001) Osteoma of the maxillary sinus. Laryngorhinootologie 80:275–277
Weber R, Draf W, Constantinidis J, Keerl R (1995) Current aspects of frontal sinus surgery. IV: On therapy of frontal sinus osteoma. HNO 43:482–486
Furlaneto EC, Rocha JR, Heitz C (2004) Osteoma of the zygomatic arch—report of a case. Int J Oral Maxillofac Surg 33:310–311
Oostvogel CW, Huttenbrink KB (1991) Pathogenesis of osteoma of the skull. Laryngorhinootologie 70:87–89
Bignami M, Dallan I, Terranova P, Battaglia P, Miceli S et al (2007) Frontal sinus osteomas: the window of endonasal endoscopic approach. Rhinology 45:315–320
Earwaker J (1993) Paranasal sinus osteomas: a review of 46 cases. Skeletal Radiol 22:417–423
Draf W, Berghaus A (1993) Tumors and pseudotumors (“tumor-like lesions”) of the frontal cranial base, originating in the nose, the paranasal sinuses and the nasopharynx (including surgical approach). Eur Arch Otorhinolaryngol Suppl 1:105–186
Eller R, Sillers M (2006) Common fibro-osseous lesions of the paranasal sinuses. Otolaryngol Clin North Am 39:585–600
Shady JA, Bland LI, Kazee AM, Pilcher WH (1994) Osteoma of the frontoethmoidal sinus with secondary brain abscess and intracranial mucocele: case report. Neurosurgery 34:920–923
Dubin MG, Kuhn FA (2006) Preservation of natural frontal sinus outflow in the management of frontal sinus osteomas. Otolaryngol Head Neck Surg 134:18–24
Busch RF (1992) Frontal sinus osteoma: complete removal via endoscopic sinus surgery and frontal sinus trephination. Am J Rhinol 6:139–143
Chiu AG, Schipor I, Cohen NA, Kennedy DW, Palmer JN (2005) Surgical decisions in the management of frontal sinus osteomas. Am J Rhinol 19:191–197
Castelnuovo P, Valentini V, Giovannetti F, Bignami M, Cassoni A et al (2008) Osteomas of the maxillofacial district: endoscopic surgery versus open surgery. J Craniofac Surg 19:1446–1452
Weber R, Draf W, Kratzsch B, Hosemann W, Schaefer SD (2001) Modern concepts of frontal sinus surgery. Laryngoscope 111:137–146
Wormald PJ (2002) The axillary flap approach to the frontal recess. Laryngoscope 112:494–499
Chen C, Selva D, Wormald PJ (2004) Endoscopic modified lothrop procedure: an alternative for frontal osteoma excision. Rhinology 42:239–243
Jones NS (2009) Sinus headaches: avoiding over- and mis-diagnosis. Expert Rev Neurother 9:439–444
Briner HR, Simmen D, Jones N (2005) Endoscopic sinus surgery: advantages of the bimanual technique. Am J Rhinol 19:269–273
Ledderose GJ, Stelter K, Leunig A, Hagedorn H (2007) Surface laser registration in ENT-surgery: accuracy in the paranasal sinuses—a cadaveric study. Rhinology 45:281–285
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ledderose, G.J., Betz, C.S., Stelter, K. et al. Surgical management of osteomas of the frontal recess and sinus: extending the limits of the endoscopic approach. Eur Arch Otorhinolaryngol 268, 525–532 (2011). https://doi.org/10.1007/s00405-010-1384-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-010-1384-y