Surgical Approach to Frontal Sinus Osteoma

A Systematic Review

Duncan C. Watley, Eric R. Mong, Nikunj A. Rana, Elisa A. Illing, Mohamad Chaaban

Research output: Contribution to journalArticle

Abstract

Background: Osteoma of the paranasal sinuses are benign bony masses most commonly found in the frontal sinus. In the past, due to the anatomical complexity of the frontal sinus, these often required an open approach, but with the invention of angled tools and endoscopes, many rhinologists are now attempting endoscopic or combined resections. No large systematic reviews currently exist that describe the surgical management of frontal sinus osteoma. Objective: To perform a systematic review detailing the surgical resection of frontal sinus osteoma. Review Methods: A systematic literature review was performed using PubMed, Embase, and Ovid databases. Data extracted included demographics, clinical presentation, radiologic, histologic findings, surgical approach, and recurrence. Results: A total of 32 studies, with 477 surgically resected tumors, were included in the analysis. Sex data were available for 179 patients (M:F, 93:86), with a mean age of 43.2 years. All resected tumors presented symptomatically: facial pain/headache (80.2%), recurrent sinusitis (30.5%), mucocele (4.3%), cosmetic deformity other than proptosis (12.8%), and proptosis (5.5%). Transnasal endoscopic surgery alone was the most common surgical approach utilized (44.9%), followed by open osteoplastic flaps (36.9%) and endoscopic assisted (18.2%). Osteoma with anterior (79%) and posterior (73%) attachments were treated statistically more often with endoscopic approach compared with floor (42%) and extrasinus (50%) attachment (P <.0005). There was no statistical difference in approach to masses that crossed the sagittal plane extending from the lamina papyracea (63% endoscopic, 29% endoscopic assisted, 8% open, P =.21). Mean follow-up was 29.7 months, with recurrence or persistent residual disease occurring in 12 patients. Conclusion: Despite the increasing use of endoscopic alone procedures for expanding indications, patients may still require an open or endoscopic assisted approach for complete removal.

Original languageEnglish (US)
JournalAmerican Journal of Rhinology and Allergy
DOIs
StatePublished - Jan 1 2019

Fingerprint

Osteoma
Frontal Sinus
Exophthalmos
Mucocele
Recurrence
Facial Pain
Endoscopes
Paranasal Sinuses
Sinusitis
PubMed
Cosmetics
Headache
Neoplasms
Demography
Databases

Keywords

  • fibro-osseous
  • fibrous dysplasia
  • frontal sinus
  • frontal sinus osteoma
  • ossifying fibroma
  • osteoma
  • sinonasal tumor
  • skull base tumor

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

Cite this

Surgical Approach to Frontal Sinus Osteoma : A Systematic Review. / Watley, Duncan C.; Mong, Eric R.; Rana, Nikunj A.; Illing, Elisa A.; Chaaban, Mohamad.

In: American Journal of Rhinology and Allergy, 01.01.2019.

Research output: Contribution to journalArticle

Watley, Duncan C. ; Mong, Eric R. ; Rana, Nikunj A. ; Illing, Elisa A. ; Chaaban, Mohamad. / Surgical Approach to Frontal Sinus Osteoma : A Systematic Review. In: American Journal of Rhinology and Allergy. 2019.
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abstract = "Background: Osteoma of the paranasal sinuses are benign bony masses most commonly found in the frontal sinus. In the past, due to the anatomical complexity of the frontal sinus, these often required an open approach, but with the invention of angled tools and endoscopes, many rhinologists are now attempting endoscopic or combined resections. No large systematic reviews currently exist that describe the surgical management of frontal sinus osteoma. Objective: To perform a systematic review detailing the surgical resection of frontal sinus osteoma. Review Methods: A systematic literature review was performed using PubMed, Embase, and Ovid databases. Data extracted included demographics, clinical presentation, radiologic, histologic findings, surgical approach, and recurrence. Results: A total of 32 studies, with 477 surgically resected tumors, were included in the analysis. Sex data were available for 179 patients (M:F, 93:86), with a mean age of 43.2 years. All resected tumors presented symptomatically: facial pain/headache (80.2{\%}), recurrent sinusitis (30.5{\%}), mucocele (4.3{\%}), cosmetic deformity other than proptosis (12.8{\%}), and proptosis (5.5{\%}). Transnasal endoscopic surgery alone was the most common surgical approach utilized (44.9{\%}), followed by open osteoplastic flaps (36.9{\%}) and endoscopic assisted (18.2{\%}). Osteoma with anterior (79{\%}) and posterior (73{\%}) attachments were treated statistically more often with endoscopic approach compared with floor (42{\%}) and extrasinus (50{\%}) attachment (P <.0005). There was no statistical difference in approach to masses that crossed the sagittal plane extending from the lamina papyracea (63{\%} endoscopic, 29{\%} endoscopic assisted, 8{\%} open, P =.21). Mean follow-up was 29.7 months, with recurrence or persistent residual disease occurring in 12 patients. Conclusion: Despite the increasing use of endoscopic alone procedures for expanding indications, patients may still require an open or endoscopic assisted approach for complete removal.",
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