Giant osteomas of the ethmoid and frontal sinuses: Clinical characteristics and review of the literature

Abstract

Giant osteomas of the ethmoid and frontal sinuses ary very rare, with only a few dozen cases reported in the literature. Given their rarity, the clinical characteristics and treatment of this disease remain controversial. In this study, the clinical presentation and surgical methods used to treat three patients with giant osteomas of the ethmoid and frontal sinuses are described, combined with a review of the literature from 1975 to 2011. In total, 45 patients with giant osteomas arising from the ethmoid and frontal sinuses (including the present cases) have been reported in 41 articles. Headache and ocular signs are the most common symptoms. This disease often leads to intracranial or intraorbital complications. The main treatment for giant osteoma is surgery via an external approach. The outcome of surgery for giant osteoma is good, with rare recurrence, no malignant transformation and few persistent symptoms.

Keywords: clinical characteristics; ethmoid sinus; frontal sinus; giant osteoma; surgery.

Figure 1

(A) An osseous lesion in the ethmoid sinus extending into the base of the frontal sinus. (B) An osseous lesion in the left ethmoid sinus extending into the orbit. (C) A computed tomography (CT) scan obtained 1 week after surgery revealed no evidence of the osteoma in coronal CT images.

Figure 2

(A) A computed tomography (CT) scan demonstrated a giant bone tumor filling in the right frontal sinus and pushing into the left frontal sinus in coronal CT images. (B) A CT scan demonstrated a giant bone tumor filling the right frontal sinus and pushing into the left frontal sinus in axial CT images. (C) The CT scan revealed total resection of the osteoma 3 months after the surgery in axial CT images.

Figure 3

(A) Computed tomography (CT) scans of the sinuses were performed and revealed a 3.5×3-cm extremely dense bony mass with inflammations in the right frontal sinus, approaching the edge of the sinus. (B) An osseous lesion in the right frontal sinus in axial CT images.