Management of osteomas of the paranasal sinuses

Craniofacial osteomas are benign tumors of the skull base, often involving the paranasal sinuses. The frontal sinus is the most common site of involve ment, followed by the ethmoid maxillary, and sphenoid sinuses, respectively . The growth rate is very slow, and it may take many years for osteomas to become clinically apl,arent. The origin of these tumors has been ascribed t o embryologic tissue maldevelopment, trauma, or infection. The turners are hard and lobulated with an ivory-like appearance, often mixed with a coarse granular component. The bone is compact or cancellous, with vascular or co nnective tissue components. The complications of osteoma growth are obstruc tion of sinus ostia, extension into adjacent bones and the intracranial cav ity, and displacement of anatomic structures. Management of uncomplicated s inus osteomas is controversial, since surgery involves serious potential ri sks. When surgery is performed, these tumors carl be successfully managed v ia endoscopic, open, or combined techniques. This article reviews the clini cal findings, diagnostic studies, and treatment of 16 patients with paranas al osteomas. The indications for surgical intervention are discussed.