Current surgical approaches to frontal ethmoid osteoma. Review of literature and own experience

Abstract

Abstract. The purpose of the article is to present current surgical approaches to the removal of frontal ethmoid osteoma. The article analyzes and describes surgical techniques used at the department of otorhinolaryngology of the Central Clinical Hospital and Polyclinic for the treatment of osteomas located in the frontal sinus, frontal recess and ethmoidal labyrinth roof. Headache and eye symptoms are the main manifestations of the disease. The method of choice for symptomatic osteoma is surgical removal of neoplasm. The article describes different types of interventions including external, endoscopic endonasal and combined approach. In external approach preference should be given to access with the formation of bicoronary osteoplastic flap. The methods is appropriate in cases when the patient is operated for the first time, the osteoma occupies the majority of the sinus or is located laterally thus making it impossible to remove it transnasally. If the patient underwent a frontal sinus surgery earlier and has a cosmetic deformity, it is feasible to resort to radical surgery on frontal sinus with fat obliteration. Endoscopic endonasal access is applied in cases where the osteoma is located in the roof of ethmoidal labyrinth or frontal recess, as well as in cases when the frontal sinus osteoma does not obstruct outflow and frontal sinusitis is caused by anatomical narrowing of nasofrontal junction. In asymptomatic osteomas watchful waiting is recommended.

Keywords

• лобная пазуха
• остеома
• решетчатый лабиринт
• компьютерная томография околоносовых пазух (кт онп)
• frontal sinus
• osteoma
• ethmoidal labyrinth
• computed tomography of the paranasal sinuses (ct pns)