nach oben

European Archives of Oto-Rhino-Laryngology

Erschienen in:

16.10.2020 | Rhinology

Gigantic paranasal sinuses osteomas: clinical features, management considerations, and long-term outcomes

verfasst von: Evangelos Giotakis, Valentinos Sofokleous, Alexander Delides, Andriana Razou, Georgios Pallis, Alexandra Karakasi, Pavlos Maragoudakis

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 5/2021

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Paranasal sinus osteomas are slow-growing, benign bony tumours that when larger than 30 mm, they are termed ‘gigantic’. Special considerations apply for tumours of this calibre, and their rarity renders their management fairly controversial. This study seeks to contribute to an increased understanding concerning their management by presenting a 12-year experience from a single institution.

Methods

Retrospective review of files of patients treated for a gigantic paranasal sinus osteoma from January 2008 to December 2019. Additionally, all patients were prospectively reexamined in early 2020 for late complications or clinical recurrence.

Results

Ten patients were included, with a mean age of 53.8 years (range: 23–77 years). The leading presenting findings were proptosis (80%) and diplopia (70%). Transient visual impairment was remarkably frequent (30%). Five patients were managed with an open approach, two with an endoscopic, and three with a combined technique. The most common adverse characteristics that dictated the use of an open approach, alone or in combination with an endoscopic approach, were the involvement of the anterior wall of the frontal sinus (40%), erosion of its posterior wall (30%), and a far-anterior intraorbital extension (30%). No major postoperative complications were observed, and also no recurrences.

Conclusion

Our study illustrates that these tumours may require a different management attitude. Despite substantial advances in the endoscopic management of benign sinonasal tumours, managing these massive tumours solely endoscopically could, in many cases, be inefficacious or impossible. Open approaches remain valuable, representing a safe and straightforward method for adequate exposure.

Lund VJ, Stammberger H, Nicolai P, Castelnuovo P, Beal T, Beham A et al (2010) European position paper on endoscopic management of tumours of the nose, paranasal sinuses and skull base. Rhinol Suppl 22:1–143PubMed

Fu YS, Perzin KH (1974) Non-epithelial tumors of the nasal cavity, paranasal sinuses, and nasopharynx: a clinicopathologic study. II. Osseous and fibro-osseous lesions, including osteoma, fibrous dysplasia, ossifying fibroma, osteoblastoma, giant cell tumor, and osteosarcoma. Cancer 33:1289–1305. https://doi.org/10.1002/1097-0142(197405)33:5%3c1289::AID-CNCR2820330514%3e3.0.CO;2-PCrossRefPubMed

McHugh JB, Mukherji SK, Lucas DR (2009) Sino-orbital osteoma: a clinicopathologic study of 45 surgically treated cases with emphasis on tumors with osteoblastoma-like features. Arch Pathol Lab Med 133:1587–1593. https://doi.org/10.1043/1543-2165-133.10.1587CrossRefPubMed

Janovic A, Antic S, Rakocevic Z, Djuric M (2013) Paranasal sinus osteoma: Is there any association with anatomical variations? Rhinology 51:54–60. https://doi.org/10.4193/Rhino12.130CrossRefPubMed

Earwaker J (1993) Paranasal sinus osteomas: a review of 46 cases. Skeletal Radiol 22:417–423. https://doi.org/10.1007/BF00538443CrossRefPubMed

Erdogan N, Demir U, Songu M, Ozenler NK, Uluç E, Dirim B (2009) A prospective study of paranasal sinus osteomas in 1889 cases: changing patterns of localization. Laryngoscope 119:2355–2359. https://doi.org/10.1002/lary.20646CrossRefPubMed

Alotaibi N, Hanss J, Benoudiba F, Bobin S, Racy E (2013) Endoscopic removal of large orbito-ethmoidal osteoma in pediatric patient: case report. Int J Surg Case Rep 4:1067–1070. https://doi.org/10.1016/j.ijscr.2013.07.035CrossRefPubMedPubMedCentral

Mansour AM, Salti H, Uwaydat S, Dakroub R, Bashshour Z (1999) Ethmoid sinus osteoma presenting as epiphora and orbital cellulitis: case report and literature review. Surv Ophthalmol 43:413–426. https://doi.org/10.1016/S0039-6257(99)00004-1CrossRefPubMed

Cheng KJ, Wang SQ, Lin L (2013) Giant osteomas of the ethmoid and frontal sinuses: clinical characteristics and review of the literature. Oncol Lett 5:1724–1730. https://doi.org/10.3892/ol.2013.1239CrossRefPubMedPubMedCentral

10.

Nguyen S, Nadeau S (2019) Giant frontal sinus osteomas: demographic, clinical presentation, and management of 10 cases. Am J Rhinol Allergy 33:36–43. https://doi.org/10.1177/1945892418804911CrossRefPubMed

11.

Wang Y, Li D, Jiang A, Zhang H, Sun Y, Liu Z et al (2016) Endoscopic resection of giant ethmoid osteomas with the assistance of an image-guidance system. Anticancer Res 36:1325–1330PubMed

12.

Hallberg OE, Begley JW (1950) Origin and treatment of osteomas of the paranasal sinuses. Arch Otolaryngol 51:750–760. https://doi.org/10.1001/archotol.1950.00700020775012CrossRefPubMed

13.

Handousa AS (1940) Nasal osteomata. J Laryngol Otol 55:197–211. https://doi.org/10.1017/S0022215100005405CrossRef

14.

Atallah N, Jay MM (1981) Osteomas of the paranasal sinuses. J Laryngol Otol 95:291–304. https://doi.org/10.1017/S0022215100090721CrossRefPubMed

15.

Rawlins AG (1938) Osteoma of the maxillary sinus. Ann Otol Rhinol Laryngol 47:735–753. https://doi.org/10.1177/000348943804700312CrossRef

16.

Samy LL, Mostafa H (1971) Osteomata of the nose and paranasal sinuses with a report of twenty one cases. J Laryngol Otol 85:449–469. https://doi.org/10.1017/S0022215100073680CrossRefPubMed

17.

Satyarthee GD, Suri A, Mahapatra AK (2015) Giant spheno-ethmoidal osteoma in a 14-year boy presenting with visual impairment and facial deformity: short review. J Pediatr Neurosci 10:48–50. https://doi.org/10.4103/1817-1745.154340CrossRefPubMedPubMedCentral

18.

Soni CR, Johnson LN (2010) Visual neuropraxia and progressive vision loss from thyroid-associated stretch optic neuropathy. Eur J Ophthalmol 20:429–436. https://doi.org/10.1177/112067211002000226CrossRefPubMed

19.

Cascone P, Rinna C, Reale G, Calvani F, Iannetti G (2012) Compression and stretching in graves orbitopathy: emergency orbital decompression techniques. J Craniofac Surg 23:1430–1433. https://doi.org/10.1097/SCS.0b013e31825e3acfCrossRefPubMed

20.

Bain AC, Meaney DF (2000) Tissue-level thresholds for axonal damage in an experimental model of central nervous system white matter injury. J Biomech Eng 122:615–622. https://doi.org/10.1115/1.1324667CrossRefPubMed

21.

Savic DL, Djeric DR (1990) Indications for the surgical treatment of osteomas of the frontal and ethmoid sinuses. Clin Otolaryngol Allied Sci 15:397–404. https://doi.org/10.1111/j.1365-2273.1990.tb00490.xCrossRefPubMed

22.

Gil-Carcedo LM, Gil-Carcedo ES, Vallejo LA, de Campos JM, Herrero D (2011) Frontal osteomas: standardising therapeutic indications. J Laryngol Otol 125:1020–1027. https://doi.org/10.1017/S0022215111001563CrossRefPubMed

23.

Castelnuovo P, Valentini V, Giovannetti F, Bignami M, Cassoni A, Iannetti G (2008) Osteomas of the maxillofacial district: endoscopic surgery versus open surgery. J Craniofac Surg 19:1446–1452. https://doi.org/10.1097/SCS.0b013e31818b417dCrossRefPubMed

24.

Smith ME, Calcaterra TC (1989) Frontal sinus osteoma. Ann Otol Rhinol Laryngol 98:896–900. https://doi.org/10.1177/000348948909801111CrossRefPubMed

25.

Pons Y, Blancal JP, Vérillaud B, Sauvaget E, Ukkola-Pons E, Kania R et al (2013) Ethmoid sinus osteoma: diagnosis and management. Head Neck 35:201–204. https://doi.org/10.1002/hed.22945CrossRefPubMed

26.

Selva D, White VA, O’Connell JX, Rootman J (2004) Primary bone tumors of the orbit. Surv Ophthalmol 49:328–342. https://doi.org/10.1016/j.survophthal.2004.02.011CrossRefPubMed

27.

Wei LA, Ramey NA, Durairaj VD, Ramakrishnan VR, Cruz AV, Dolman PJ et al (2014) Orbital osteoma: clinical features and management options. Ophthalmic Plast Reconstr Surg 30(2):168–174. https://doi.org/10.1097/IOP.0000000000000039CrossRefPubMed

28.

Fetissof AG (1929) Pathogenesis of osteomas of the nasal accessory sinuses. Ann Otol Rhinol Laryngol 38:404–420. https://doi.org/10.1177/000348942903800210CrossRef

29.

Chang SCN, Chen PKT, Chen YR, Chang CN (1997) Treatment of frontal sinus osteoma using a craniofacial approach. Ann Plast Surg 38:455–459. https://doi.org/10.1097/00000637-199705000-00004CrossRefPubMed

30.

Gibson T, Walker FM (1951) Large osteoma of the frontal sinus. A method of removal to minimise scarring and prevent deformity. Br J Plast Surg 4:210–217. https://doi.org/10.1016/S0007-1226(51)80037-7CrossRefPubMed

31.

Zouloumis L, Lazaridis N, Maria P, Epivatianos A (2005) Osteoma of the ethmoidal sinus: a rare case of recurrence. Br J Oral Maxillofac Surg 43:520–522. https://doi.org/10.1016/j.bjoms.2005.01.014CrossRefPubMed

32.

Schick B, Steigerwald C, El Tahan AER, Draf W (2001) The role of endonasal surgery in the management of frontoethmoidal osteomas. Rhinology 39:66–70PubMed

33.

Seiberling K, Floreani S, Robinson S, Wormald PJ (2009) Endoscopic management of frontal sinus osteomas revisited. Am J Rhinol Allergy 23:331–336. https://doi.org/10.2500/ajra.2009.23.3321CrossRefPubMed

34.

Weber R, Draf W, Kratzsch B, Hosemann W, Schaefer SD (2001) Modern concepts of frontal sinus surgery. Laryngoscope 111:137–146. https://doi.org/10.1097/00005537-200101000-00024CrossRefPubMed

35.

Busch RF (1992) Frontal sinus osteoma : complete removal via endoscopic sinus surgery and frontal sinus trephination. Am J Rhinol 6:139–143. https://doi.org/10.2500/105065892781874612CrossRef

36.

Kennedy DW, Keogh B, Senior B, Lanza DC (1996) Endoscopic approach to tumors of the anterior skull base and orbit. Oper Tech Otolaryngol Head Neck Surg 7:257–263. https://doi.org/10.1016/S1043-1810(96)80043-1CrossRef

37.

Chiu AG, Schipor I, Cohen NA, Kennedy DW, Palmer JN (2005) Surgical decisions in the management of frontal sinus osteomas. Am J Rhinol 19:191–197. https://doi.org/10.1177/194589240501900213CrossRefPubMed

38.

Georgalas C, Goudakos J, Fokkens WJ (2011) Osteoma of the skull base and sinuses. Otolaryngol Clin North Am 44:875–890. https://doi.org/10.1016/j.otc.2011.06.008CrossRefPubMed

39.

Ledderose GJ, Betz CS, Stelter K, Leunig A (2011) Surgical management of osteomas of the frontal recess and sinus: extending the limits of the endoscopic approach. Eur Arch Oto-Rhino-Laryngol 268:525–532. https://doi.org/10.1007/s00405-010-1384-yCrossRef

40.

Bignami M, Dallan I, Terranova P, Battaglia P, Miceli S, Castelnuovo P (2007) Frontal sinus osteomas: the window of endonasal endoscopic approach. Rhinology 45:315–320. https://doi.org/10.1016/S1041-892X(08)79124-8CrossRefPubMed

41.

Dubin MG, Kuhn FA (2006) Preservation of natural frontal sinus outflow in the management of frontal sinus osteomas. Otolaryngol Head Neck Surg 134:18–24. https://doi.org/10.1016/j.otohns.2005.09.020CrossRefPubMed

42.

Turri-Zanoni M, Dallan I, Terranova P, Battaglia P, Karligkiotis A, Bignami M et al (2012) Frontoethmoidal and intraorbital osteomas: exploring the limits of the endoscopic approach. Arch Otolaryngol Head Neck Surg 138:498–504. https://doi.org/10.1001/archoto.2012.644CrossRefPubMed

43.

Karligkiotis A, Pistochini A, Turri-Zanoni M, Terranova P, Volpi L, Battaglia P et al (2015) Endoscopic endonasal orbital transposition to expand the frontal sinus approaches. Am J Rhinol Allergy 29:449–456. https://doi.org/10.2500/ajra.2015.29.4230CrossRefPubMed

44.

Timperley DG, Banks C, Robinson D, Roth J, Sacks R, Harvey RJ (2011) Lateral frontal sinus access in endoscopic skull-base surgery. Int Forum Allergy Rhinol 1:290–295. https://doi.org/10.1002/alr.20042CrossRefPubMed

45.

Sofokleous V, Maragoudakis P, Kyrodimos E, Giotakis E (2020) Management of paranasal sinus osteomas: a comprehensive narrative review of the literature and an up-to-date grading system. Am J Otolaryngol. https://doi.org/10.1016/j.amjoto.2020.102644CrossRefPubMed

Titel: Gigantic paranasal sinuses osteomas: clinical features, management considerations, and long-term outcomes
verfasst von: Evangelos Giotakis
Valentinos Sofokleous
Alexander Delides
Andriana Razou
Georgios Pallis
Alexandra Karakasi
Pavlos Maragoudakis
Publikationsdatum: 16.10.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: European Archives of Oto-Rhino-Laryngology / Ausgabe 5/2021
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-020-06420-x

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Springer Medizin

Gigantic paranasal sinuses osteomas: clinical features, management considerations, and long-term outcomes