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Frontal osteomas: standardising therapeutic indications

Published online by Cambridge University Press:  18 July 2011

L M Gil-Carcedo ,
E S Gil-Carcedo ,
L A Vallejo ,
J M de Campos  and
D Herrero
L M Gil-Carcedo*
Affiliation:
Department of Otolaryngology, Rio Hortega Hospital, Valladolid University Hospital, Valladolid University, Spain
E S Gil-Carcedo
Affiliation:
Department of Otolaryngology, Rio Hortega Hospital, Valladolid University Hospital, Valladolid University, Spain
L A Vallejo
Affiliation:
Department of Otolaryngology, Rio Hortega Hospital, Valladolid University Hospital, Valladolid University, Spain
J M de Campos
Affiliation:
Department of Neurosurgery, Jimenez Diaz Foundation Hospital, Autonomous University of Madrid, Spain
D Herrero
Affiliation:
Department of Otolaryngology, Rio Hortega Hospital, Valladolid University Hospital, Valladolid University, Spain
*
Address for correspondence: Dr Luis M Gil-Carcedo, Calle Teresa Gil 16, 3°, 47002 Valladolid, Spain Fax: +34 983 306231 E-mail: gilcarsa@telefonica.net
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Abstract

Background:

We believe the currently accepted indications for frontal osteoma surgery are inappropriate. We propose a new osteoma classification system, below, in order to standardise surgical decisions.

Method:

Osteomas were classified based on: relationship of tumour mass to sinus size; tumour proximity to the infundibulum, destruction of sinus walls, and complications. Forty-five osteoma cases were thus classified (1971–2007), 29 of which underwent surgery (64.44 per cent).

Results:

Three stages were thus derived: I, tumour/air fraction less than one-third, tumour distant from the infundibulum, no sinusitis, and no complications (18 patients (40 per cent)); II, tumour/air fraction one-third to one-half, no infundibular obstruction, no bone destruction, no sinusitis, and no complications (six (13.33 per cent)); and III, tumour/air fraction more than one-half, partial or total infundibular obstruction, sinusitis, bone destruction, and/or complications (21 (46.67 per cent)).

Conclusion:

Study findings suggest the following surgical indications: stage I, no surgery required, implement monitoring protocol; stage II, implement monitoring protocol, surgery may be required depending on tumour severity and general patient condition; and stage III, surgery always required. This system provides a method of standardising osteoma surgical decisions.

Keywords

Paranasal SinusesOsteomasFrontal SinusSurgical Therapy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 10 , October 2011 , pp. 1020 - 1027
Copyright
Copyright © JLO (1984) Limited 2011

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References

1Koivunen, P, Löppönen, H, Pfors, A, Jokinen, K. The growth rate of osteomas of the paranasal sinus. Clin Otolaryngol 1997;22:111–14CrossRefGoogle Scholar
2Earwalker, J. Paranasal sinus osteomas: a review of 46 cases. Skel Radiol 1993;22:417–23CrossRefGoogle Scholar
3Zouloumis, L, Lazaridis, N, Papadaki, M, Epivatianos, A. Osteoma of the ethmoid sinus: a rare case of recurrence. Br J Oral Maxillofac Surg 2005;43:520–2CrossRefGoogle ScholarPubMed
4Childrey, JH. Osteoma of sinuses, the frontal and sphenoid bone. Arch Otolaryngol 1939;30:63–72CrossRefGoogle Scholar
5Mehta, BS, Grewal, GS. Osteoma of the paranasal sinus along with the case of an orbito-ethmoidal osteoma. J Laryngol Otol 1960;77:601–10CrossRefGoogle Scholar
6Bourgeois, P, Gichten, A, Louis, E, Vincent, C, Pertuzon, B, Assaker, R. Neuro-ophthalmological complications of frontal sinus osteomas [in French]. Neurochirurgie 2002;48:104–8Google ScholarPubMed
7Nabeshima, K, Marutsuka, K, Shimao, Y, Uehara, H, Kodama, T. Osteoma of the frontal sinus complicated by intracranial mucocele. Pathol Int 2003;53:227–30CrossRefGoogle ScholarPubMed
8Dispenza, C, Saraniti, C, Ferrara, S, Martines, F, Caramanna, C, Salzano, FA. Frontal sinus osteoma and palpebral abscess: case report [in French]. Rev Laryngol Otol Rhinol (Bord) 2005;126:49–51Google ScholarPubMed
9Namdar, I, Edelstein, DR, Huo, J, Lazar, A, Kimmelman, ChP, Soletic, R. Management of osteomas of the paranasal sinuses. Am J Rhinol 1998;12:393–8CrossRefGoogle ScholarPubMed
10Karapantzos, I, Detorakis, ET, Drakonaki, EE, Ganasouli, DL, Danielides, V, Kozobolis, VP. Ethmoidal osteoma with intraorbital extension: excision through a transcutaneous paranasal incision. Acta Ophthalmol Scand 2005;83:392–4CrossRefGoogle ScholarPubMed
11Onal, B, Kaymaz, M, Arac, M, Dogulu, F. Frontal sinus osteoma associated with pneumocephalus. Diagn Interv Radiol 2006;12:174–6Google ScholarPubMed
12Hartwidge, C, Varma, TR. Intracranial aeroceles as a complication of frontal sinus osteoma. Surg Neurol 1984;24:401–4CrossRefGoogle Scholar
13Huneidi, AH, Afshar, F. Chronic spontaneous tension pneumocephalus due to benign frontal osteoma. Br J Neurosurg 1989;3:389–92CrossRefGoogle Scholar
14Roca, B, Casado, O, Borras, JM, Gonzalez-Darder, JM. Frontal brain abscess due to Streptococcus pneumoniae associated with an osteoma. Int J Infect Dis 2004;8:193–4CrossRefGoogle ScholarPubMed
15Panagiotopoulos, V, Tzortzidis, F, Partheni, M, Iliadis, H, Fratzoglou, M. Giant osteoma of the frontoethmoidal sinus associated with two cerebral abscesses. Br J Oral Maxillofac Surg 2005;43:523–5CrossRefGoogle ScholarPubMed
16Smith, ME, Calcaterra, TC. Frontal sinus osteoma. Ann Otol Rhinol Laryngol 1989;98:896–900CrossRefGoogle ScholarPubMed
17Atallah, N, Jay, MM. Osteomas of the paranasal sinuses. J Laryngol Otol 1981;95:291–304CrossRefGoogle ScholarPubMed
18Savic, DLJ, Djeric, DR. Indications for the surgical treatment of osteomas of the frontal and ethmoid sinuses. Clin Otolaryngol 1990;15:397–404CrossRefGoogle ScholarPubMed
19Woldenberg, Y, Nash, M, Bodner, L. Peripheral osteoma of the maxillofacial region. Diagnosis and management: a study of 14 cases. Med Oral Patol Oral Cir Bucal 2005;10(suppl 2):139–42Google ScholarPubMed
20Izci, Y. Management of the large cranial osteoma: experience with 13 adult patients [in German]. Acta Neurochir (Wien) 2005;147:1151–5CrossRefGoogle ScholarPubMed
21Klonowski, S, Klatka, J, Szymanski, M. Giant osteoma of the ethmoid sinus and frontal sinuses [in Polish]. Otolaryngol Pol 2005;59:899–901Google ScholarPubMed
22Rodriguez Prado, N, Llorente Pendás, JL, Del Campo Rodriguez, A, Puente Verez, M, Suarez Nieto, C. Paranasal sinus osteomas. Revision of 14 cases [in Spanish]. Acta Otorrinolaringol Esp 2004;55:225–30CrossRefGoogle ScholarPubMed
23Chiu, AG, Schipor, I, Cohen, NA, Kennedy, DW, Palmer, JN. Surgical decisions in the management of frontal sinus osteomas. Am J Rhinol 2005;9:191–7CrossRefGoogle Scholar
24Chen, C, Selva, D, Wormald, PJ. Endoscopic modified Lothrop procedure: an alternative for frontal osteoma excision. Rhinology 2004;42:239–43Google ScholarPubMed
25Dubin, MG, Kuhn, FA. Preservation of natural frontal sinus outflow in the management of frontal sinus osteomas. Otolaryngol Head Neck Surg 2006;134:18–24CrossRefGoogle ScholarPubMed
26Spencer, MG, Mitchelli, DB. Growth of a frontal sinus osteoma. J Laryngol Otol 1987;101:726–8CrossRefGoogle ScholarPubMed
27Gil-Carcedo, LM, Alarcos, E, Alarcos, A, Izquierdo, JM. Osteomas. Presentation of 26 cases. I. General characteristics. Clinical symptoms [in Spanish]. Anales ORL Iber Amer 1987;14:201–24Google Scholar
28Gil-Carcedo, LM, Izquierdo, JM, Alarcos, E, Alarcos, A. Osteomas. II. Differential diagnosis [in Spanish]. Anales ORL Iber Amer 1987;14:285–300Google ScholarPubMed
29Gil-Carcedo, LM, Alarcos, E, Alarcos, A, Izquierdo, JM. Osteomas. III. Therapeutic indications. Treatment [in Spanish]. Anales ORL Iber Amer 1987;14:369–87Google Scholar
30Seiberling, K, Floreani, S, Robinson, S, Wormald, PJ. Endoscopic management of frontal sinus osteomas revisited. Am J Rhinol Allergy 2009;23:331–6CrossRefGoogle ScholarPubMed
31Close, LG. Endoscopic Lothrop procedure: when should it be considered? Curr Opin Otolaryngol Head Neck Surg 2005;13:67–9CrossRefGoogle ScholarPubMed