Gigantic paranasal sinuses osteomas: clinical features, management considerations, and long-term outcomes
- PDF / 1,754,655 Bytes
- 13 Pages / 595.276 x 790.866 pts Page_size
- 25 Downloads / 171 Views
RHINOLOGY
Gigantic paranasal sinuses osteomas: clinical features, management considerations, and long‑term outcomes Evangelos Giotakis1 · Valentinos Sofokleous1 · Alexander Delides2 · Andriana Razou1 · Georgios Pallis1 · Alexandra Karakasi1 · Pavlos Maragoudakis2 Received: 14 August 2020 / Accepted: 3 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
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. Keywords Gigantic osteoma · Frontal sinus · Ethmoid sinus · Endoscopic sinus surgery · Osteoplastic flap procedure
Introduction Osteomas are slow-growing, benign, bony tumours that are most commonly diagnosed incidentally on routine radiological examinations. They constitute the most common benign neoplasm of the nose and paranasal sinuses, involving mainly the frontal sinus and ethmoid labyrinth * Valentinos Sofokleous [email protected] 1
Department of Otorhinolaryngology ‑ Head and Neck Surgery, General Hospital of Athens “Hippokration”, National and Kapodistrian University of Athens, Athens, Greece
Department of Otorhinolaryngology ‑ Head and Neck Surgery, “Attikon” University Hospital, National and Kapodistrian University of Athens, Athens, Greece
2
[1]. Histologically, they are composed of mature, hyperplastic osseous tissue, which always remains well-demarcated from normal surrounding tissues, and c
Data Loading...
