Endoscopic approach for paranasal sinuses osteomas: Our experience and review of literature

Osteomas are common benign bone tumors of the skull and facial structures involving primarily the cranial vault, mandible, external auditory canal, paranasal sinuses, nasal cavity, and orbit.12 These neoplasms are usually asymptomatic and account for 0.43% of tumor in population with an incidental finding on 1% of radiographs and on 3% of computed tomography (CT) scans. [1] These solid nodular sclerotic lesions usually arise from the outer table and are usually < 10 mm; lesions larger than 30 mm in diameter are considered giant tumors. 3,4,7 Most of patients with such a diagnosis have few or no symptoms, in general only 10% is symptomatic, in the second to fifth decades of life 5,6 . In literature, endoscopic endonasal approaches are mainly indicated for small ethmoidal osteomas without significant orbital or frontal extension 7 , while large osteomas require Caldwell-Luc surgery 8 or other more aggressive approaches 25 . We report our experience about the treatment of paranasal sinuses osteomas treated endoscopically or by endoscope-assisted Caldwell-Luc approach, achieving total removal of the neoplasms with all the advantages deriving by endoscopic technique such as closer visualization of the anatomy, no damage to the surrounding structures, better cosmetic results, less morbidity and shorter hospitalization 17 .