Turri-Zanoni Mario, Dallan Iacopo, Terranova Paola, Battaglia Paolo, Karligkiotis Apostolos, Bignami Maurizio, Castelnuovo Paolo
Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy.
Arch Otolaryngol Head Neck Surg. 2012 May;138(5):498-504. doi: 10.1001/archoto.2012.644.
To review our experience with the surgical treatment of frontoethmoidal osteomas, focusing on the osteomas that were either localized laterally in the frontal sinus or showing intraorbital involvement.
Retrospective evaluation.
Tertiary care center.
Patients with symptomatic frontoethmoidal or intraorbital osteomas who had been treated surgically from 1996 through 2011.
Sixty frontoethmoidal osteomas were treated surgically. The lesion involved the far lateral portion of the frontal sinus in 23 cases and the orbital region in 6 cases. In 31 cases, a purely endoscopic approach was performed while a combined procedure was used in 25 patients. In 4 patients, an exclusively external approach was required.
No recurrence of osteoma.
Radical resection was obtained, except in the case of 2 lesions. No osteoma recurrence was observed during a mean follow-up of 72.6 months.
The size of the osteoma, far lateral extension of the tumor in the frontal sinus beyond the lamina papyracea, and intraorbital involvement are no longer absolute contraindications for purely transnasal endoscopic resection. What is important is that the surgeon should not be dogmatic but rather be ready to change his or her mind during surgery, shifting to an external approach when required.
回顾我们在额筛骨瘤手术治疗方面的经验，重点关注位于额窦外侧或累及眶内的骨瘤。
回顾性评估。
三级医疗中心。
1996年至2011年期间接受手术治疗的有症状的额筛骨瘤或眶内骨瘤患者。
60例额筛骨瘤接受了手术治疗。病变累及额窦最外侧部分23例，累及眶区6例。31例采用单纯内镜手术，25例采用联合手术。4例需要单纯外部手术。
骨瘤无复发。
除2例病变外均实现根治性切除。平均随访72.6个月期间未观察到骨瘤复发。
骨瘤大小、肿瘤在额窦内超出纸样板的最外侧延伸以及眶内累及不再是单纯经鼻内镜切除的绝对禁忌证。重要的是，外科医生不应教条，而应在手术过程中随时准备改变主意，必要时转为外部手术。
