SINONASAL FIBROUS DYSPLASIA: OUR 10-YEARS EXPERIENCE

Abstract

Fibrous dysplasia (FD) is a rare benign bone tumor characterized by replacement of normal bone by fibro-osseous connective tissue. FD accounted for 7 % of all the benign bone tumors. The incidence of FD involving the sinonasal tract is unknown. The purpose of this study was to assess the incidence of sinonasal involvement by FD, to analyze the clinical characteristics, radiological features, and management of patients with fibrous dysplasia in order to understand the indications for surgical treatment. We also present some CT images of our patients to demonstrate typical radiographic signs of FD. Materials and methods: a retrospective review of 19 patients. Distribution of the cases according to the clinical and radiological features was described, management and results were presented. Results: among 78 patients with craniofacial FD, 19 (24, 36%) patients presented sinonasal involvement. The average age was 47 years. 1patient was with monostotic form, the rest 18 – with polyostotic. The most common site of the lesion was sphenoid and ethmoid sinuses, the most common complaint – headache, less often – nasal obstruction with or without nasal discharge.16 patients underwent purely endoscopic removal, the rest 3 – combined neurosurgery with endoscopic assistance. Median follow-up period was 21 months, and there were no continued growth in our observed group. Conclusions: FD is a very rare pathology. In this particular group of patients, endoscopic treatment showed a good result, but this pathology still needs to be further studied, and patients require a long-term follow-up. Endoscopic surgery is challenging as FD bleeds freely, and should be only contemplated by an experienced rhinologist.

Keywords

• Fibrous dysplasia
• sinonasal fibrous dysplasia
• skull base
• functional endoscopic sinus surgery