Fobe Lisete Pessoa de Oliveira, Melo Erich Christiano de, Cannone Luiz Fernando, Fobe Jean-Luc
Hospital do Servidor Público, SP, Brasil.
Arq Neuropsiquiatr. 2002 Mar;60(1):101-5. doi: 10.1590/s0004-282x2002000100018.
Frontal sinus osteomas are 57% of all paranasal sinus osteomas, with an incidence of 00.1 to 3%. Surgical removal of the frontal sinus osteomas is done in symptomatic patients. Asymptomatic patients can be managed conservatively or submitted to surgery in spite of its location or extension. Five patients having the diagnosis of frontal sinus osteoma were operated on between 1995 and 1999. Medium age was 38.4 years (from 12 to 55 years), 3 male and 2 female. Symptoms occurred from 6 months to 3 years, average of 10.5 months. Four patients had previous headache and one had epistaxis. All patients had standard radiological exams and computed tomography with coronal and axial studies of paranasal sinus. In two patients the diameter of the osteoma was larger than 3 cm and in three smaller than 3 cm. The choice between coronal and supraciliar approach was made according to esthetics, supraciliar approach was made in only one bald patient even with the tumor being large and extending to ethmoidal sinus. Any intra operative difficulty was related to the choice of the approach. Naso-frontal ostium was not obstructed in intra operative course. Minimal postoperative follow up was of two years. Osteomas were radically removed in all patients with no recurrence or residual tumor. Clinical findings, radiological exams and surgical approaches are discussed. No postoperative complications occurred.
额窦骨瘤占所有鼻窦骨瘤的57%，发病率为0.1%至3%。有症状的患者需手术切除额窦骨瘤。无症状患者无论其位置或范围如何，均可采取保守治疗或接受手术。1995年至1999年间，对5例诊断为额窦骨瘤的患者进行了手术。平均年龄为38.4岁（12岁至55岁），男性3例，女性2例。症状出现时间为6个月至3年，平均10.5个月。4例患者曾有头痛症状，1例有鼻出血症状。所有患者均进行了标准的放射学检查以及鼻窦的冠状位和轴位计算机断层扫描。2例患者的骨瘤直径大于3厘米，3例小于3厘米。根据美学因素选择冠状切口或眉上切口，即使肿瘤较大且延伸至筛窦，也仅对1例秃头患者采用了眉上切口。术中的任何困难都与手术入路的选择有关。术中鼻额管未受阻。术后最短随访时间为两年。所有患者的骨瘤均被彻底切除，无复发或残留肿瘤。文中讨论了临床表现、放射学检查和手术入路。术后未发生并发症。
