Hostname: page-component-848d4c4894-75dct Total loading time: 0 Render date: 2024-05-09T03:42:52.524Z Has data issue: false hasContentIssue false
  • English
  • Français

Rare giant frontal sinus osteoma mimicking fibrous dysplasia

Published online by Cambridge University Press:  23 March 2015

R P Exley ,
A Markey ,
S Rutherford  and
R K Bhalla
R P Exley
Affiliation:
Department of ENT Surgery, Tameside Hospital, Ashton-under-Lyne, UK
A Markey
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Manchester Royal Infirmary, UK
S Rutherford
Affiliation:
Department of Neurosurgery, Salford Royal Hospital, UK
R K Bhalla*
Affiliation:
Manchester Academic Health Science Centre, Central Manchester University Foundation Trust, University of Manchester, UK
*
Address for correspondence: Mr R K Bhalla, Department of Otolaryngology – Head and Neck Surgery, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK Fax: (0161) 276 5003 E-mail: rajiv.bhalla@cmft.nhs.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To present the first report of a giant frontal sinus osteoma treated by excision and single-stage reconstruction with custom-made titanium cranioplasty and left orbital roof prostheses.

Case report:

A 31-year-old man with a history of chronic frontal sinusitis presented with a deforming, painless, midline forehead swelling of 11 years' duration, which had been treated unsuccessfully in Nigeria. Differential diagnosis included both benign and malignant bony tumours. Computerised tomography revealed a giant bony frontal sinus tumour extending beyond the sinus roof and breaching the left orbit, consistent with fibrous dysplasia. Given the extent of the tumour, open craniectomy was performed for surgical extirpation. Histological analysis identified multiple osteomas. This surgical approach achieved excellent cosmesis, with no evidence of recurrence at 12-month follow up.

Conclusion:

Forehead swelling may pose diagnostic and management dilemmas for the ENT surgeon; however, effective management is facilitated by a multidisciplinary approach.

Keywords

Frontal SinusOsteomaFibrous Dysplasia of BoneTitaniumAdult
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 3 , March 2015 , pp. 283 - 287
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the 142nd Semon Club meeting, 10th November 2011, Guy's Hospital, London, UK.

References

1Earwalker, J. Paranasal sinus osteomas: a review of 46 cases. Skeletal Radiol 1993;22:417–23CrossRefGoogle Scholar
2Zouloumis, L, Lazaridis, N, Papadaki, M, Epivatianos, A. Osteoma of the ethmoid sinus: a rare case of recurrence. Br J Oral Maxillofac Surg 2005;43:520Google Scholar
3Castelnuovo, P, Valentini, V, Giovannetti, F, Bignami, M, Cassoni, A, Iannetti, G. Osteomas of the maxillofacial district: endoscopic surgery versus open surgery. J Craniofac Surg 2008;19:6Google Scholar
4Brannon, RB, Fowler, CB. Benign fibro-osseous lesions: a review of current concepts. Adv Anat Pathol 2001;8:126–43Google Scholar
5Patel, TR, Borah, GL. Frontal bone periosteal osteomas. Plast Reconstr Surg 2004;114:648–51Google Scholar
6Childrey, JH. Osteoma of the sinuses, the frontal and the sphenoid bone. Arch Otolaryngol Head Neck Surg 1939;30:63–72CrossRefGoogle Scholar
7Seiden, A, El Hefny, Y. Endoscopic trephination for the removal of frontal sinus osteoma. Otolaryngol Head Neck Surg 1995;112:607–611Google Scholar
8Onishi, K, Maruyama, Y, Sawaizumi, M. Endoscopic excision of forehead osteoma. J Craniofac Surg 1995;6:516Google Scholar
9Panagiotopoulos, 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;43:523–5Google Scholar
10Leiberman, A, Tovi, F. A small osteoma of the frontal sinus causing headaches. J Laryngol Otol 1984;98:1147–9CrossRefGoogle ScholarPubMed
11Summers, LE, Mascott, CR, Tompkins, JR, Richardson, DE. Frontal sinus osteoma associated with cerebral abscess formation: a case report. Surg Neurol 2001;55:235CrossRefGoogle ScholarPubMed
12DiCaprio, MR, Enneking, WF. Fibrous dysplasia. pathophysiology, evaluation, and treatment. J Bone Joint Surg Am 2005;87:1848–64Google Scholar
13Som, PM, Brandwein, M. Tumors and tumor-like conditions. In:Som, PM, Curtin, HD, eds. Head and Neck Imaging, 4th edn.St Louis: Mosby, 2003;331–40Google Scholar
14Idowu, BD, Al-Adnani, M, O'Donnell, P, Yu, L, Odell, E, Diss, T et al. A sensitive mutation-specific screening technique for GNAS1 mutations in cases of fibrous dysplasia: the first report of a codon 227 mutation in bone. Histopathology 2007;50:691–704Google Scholar
15Muto, T, Michiya, H, Kanazawa, M, Sato, T. Pathological calcification of the cervico-facial region. Br J Oral Maxillofac Surg 1991;29:120–2Google Scholar
16Del Balso, AM, Werning, JT. The role of computer tomography in the evaluation of a cemento-osseous lesion. Oral Surg Oral Med Oral Pathol 1986;62:354Google Scholar
17Shibata, Y, Yoshii, Y, Tsukada, A, Nose, T. Radiolucent osteoma of the skull. Case report. Neurosurgery 1991;29:776–8CrossRefGoogle ScholarPubMed
18Haddad, FS, Hadded, GF, Zaatari, G. Cranial osteoma: their classification and management: report on a giant osteoma and review of the literature. Surg Neurol 1997;48:143–7Google Scholar
19Savastano, M, Guarda-Nardini, L, Marioni, G, Staffieri, A. The bicoronal approach for the treatment of a large frontal sinus osteoma. A technical note. Am J Otolaryngol 2007;28:427–9Google Scholar
20Goodale, RL, Montgomery, W. Anterior osteoplastic frontal sinus operation. Ann Otol Rhinol Laryngol 1961;70:860–80Google Scholar
21Chiu, AG, Schipor, I, Cohen, NA, Kennedy, DW, Palmer, JN. Surgical decisions in the management of frontal sinus osteomas. Am J Rhinol 2005;19:191–7Google Scholar
22Hardy, JM, Montgomery, WW. Osteoplastic frontal sinusotomy: an analysis of 250 operations. Ann Otol Rhinol Laryngol 1976;85:523–32Google Scholar
23Fobe, LP, Melo, EC. Osseous lesions. In: Fechner RE, Mills, SE, eds. Tumours of the Bones and Joints, Atlas of Tumor Pathology, 3rd Series, fascicle 8. Washington DC: Armed Forces Institute of Pathology 1993;26–8Google Scholar
24Gossios, K, Bai, M, Psilas, K. Giant aggressive osteoma of the frontal sinus. Clin Radiol 1950;54:193–6Google Scholar
25Koyuncu, M, Belet, U, Sesen, T. Huge osteoma of the frontoethmoidal sinus with secondary brain abscess. Auris Nasus Larynx 2000;27:285–7CrossRefGoogle ScholarPubMed
26Ataman, M, Ayas, K, Gursel, B. Giant osteoma of the frontal sinus. Rhinology 1993;31:185–7Google ScholarPubMed
27Bushan, B, Watal, G, Ahmed, A, Saxena, R, Goswami, K, Pathania, AG. Giant ivory osteoma of frontal sinus. Australas Radiol 1987;31:306–8Google Scholar
28Ozerdem, OR, Sen, O, Anlatici, R, Erdogan, B, Aydin, V. Osteogaleal flaps in pediatric cranioplasty. Ann Plast Surg 2002;49:127–132Google Scholar
29Musliston, TAH, Stafford, N. A cranio-facial approach to large osteomas of the fronto-ethomoidal region. J Laryngol Otol 1985;99:979–83Google Scholar
30Inoue, A, Satoh, S, Sekiguchi, K, Ibuchi, Y, Katoh, S, Ota, K, Fujimori, S. Cranioplasty with split-thickness calvarial bone. Neurol Med Chir (Tokyo) 1995;35:804–7CrossRefGoogle ScholarPubMed
31Taggard, DA, Menezes, AH. Successful use of rib grafts for cranioplasty in children. Pediatr Neurosurg 2001;34:149–155CrossRefGoogle ScholarPubMed
32Chen, TM, Wang, HJ. Cranioplasty using allogeneic perforated demineralized bone matrix with autogenous bone paste. Ann Plast Surg 2002;49:272–9Google Scholar
33Prolo, DJ, Oklund, SA. The use of bone grafts and alloplastic materials in cranioplasty. Clin Orthop 1991;268:270–8Google Scholar
34Marchac, D, Greensmith, A. Long-term experience with methylmethacrylate cranioplasty in craniofacial surgery. J Plast Reconstr Aesthet Surg 2008;61:744–75Google Scholar
35Pang, D, Tse, HH, Zwienenberg-Lee, M, Smith, M, Zovickian, J. The combined use of hydroxyapatite and bioresorbable plates to repair cranial defects in children. J Neurosurg 2005;102:36–43Google ScholarPubMed
36O'Broin, ES, Morrin, M, Breathnach, E, Allcutt, D, Earley, MJ. Titanium mesh and bone dust calvarial patch during cranioplasty. Cleft Palate Craniofac J 1997;34:354–6Google Scholar
37Hayden, MG, Guzman, R, Dulai, M, Mobley, BC, Edwards, MSB. Recurring osteoma within calcium phosphate bone cement cranioplasty: case report. Neurosurgery 2009;64:775–6Google Scholar
38Joffe, JM, McDermott, PJC, Linney, AD, Mosse, C, Harris, M. Computer-generated titanium cranioplasty: report of a new technique for repairing skull defects. Br J Neurosurg 1992;6:343–50CrossRefGoogle ScholarPubMed