Transnasal vs. combined resection of Osteomas of the paranasal sinuses and skull base

Introduction Osteomas of the paranasal sinuses are rare benign tumors that are often incidentally diagnosed during imaging. Frequently, these tumors do not cause any symptoms. However, depending on their size, they can lead to drainage problems with subsequent complaints such as headaches or a feeling of pressure. Additionally, complications such as periorbital swelling, diplopia, meningitis, and abscess formation along the skull base or intracranially may occur.

Methods An evaluation of the course and surgical procedures of patients operated on due to advanced symptomatic osteomas at the ENT University Hospital Ulm was conducted. Based on this, an algorithm for deciding on the surgical approach was developed.

Results Nine patients were included in the study. The osteomas were located in the ethmoid and frontal sinuses. Five cases were treated endoscopically, and four were treated using combined approaches. In three cases, the surgery was performed in an interdisciplinary setting with colleagues from neurosurgery. Preoperative CT images were divided into anatomical regions, and recommendations for planning the surgical approaches were made based on the results.

Discussion/Conclusion Despite significant advances in endoscopic techniques, the open or combined approach remains an important alternative. Close collaboration with neurosurgery and oral and maxillofacial surgery is advantageous depending on the location and size of the osteomas.

Publication History

Article published online:
19 April 2024