TREATMENT OF FRONTAL-SINUS OSTEOMA USING A CRANIOFACIAL APPROACH

Osteoma is one of most common benign tumors of the nose and paranasal sinuses, with the frontal sinus being its most frequent location. It m ay be locally destructive and aggressive with possible intracranial co mplications. Osteoma of the frontal sinus comprises 57% of all osteoma s in the paranasal sinuses, In 1939, Childrey reviewed 3,510 consecuti ve sinus radiographs taken for any reason and found an incidence of 0. 43% of paranasal sinus osteomas. There are many operative approaches f or frontal sinus osteomas, such as external frontoethmoidal approach a nd osteoplastic frontal sinusectomy, both with high recurrence rates, Those traditional operative methods cannot radically eradiate the oste oma grown in the posterior table of the frontal sinus. From July 1991 to June 1992, three patients with symptomatic frontal sinus osteomas w ere operated by a craniofacial approach. One patient is presented here in detail. A coronal incision is used and is found to be beneficial b oth in surgical exposure and in reconstruction with a calvarial bone g raft. The patient has been followed for 3.5 years without osteoma recu rrence.