Department of Neurosciences and Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University "Federico II" of Naples, Naples, Italy.
Department of Neurosciences and Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University "Federico II" of Naples, Naples, Italy.
World Neurosurg. 2024 Oct;190:339-341. doi: 10.1016/j.wneu.2024.07.177. Epub 2024 Jul 31.
Parasinusal osteoma complicated by intracranial and orbit extension, cranial vault hyperostosis, intracranial mucocele, and inflammatory pseudotumor is exceptional. A 68-year-old man presented with a long history of progressive proptosis and recurrent episodes of keratoconjunctivitis in the left eye, with restriction in upward gaze. Contrast-enhanced magnetic resonance imaging revealed a frontal sinus lesion extending to the left anterior fossa and orbit, featuring an intracranial cystic component and heterogeneous contrast enhancement. Head computed tomography confirmed the double calcific-cystic nature of the lesion. A left supraorbital-pterional approach allowed complete resection of mucocele and drilling of intracranial and orbital osteoma, including the intrasinusal component. The frontal sinus was cranialized, and a flap of pericranium, reinforced by Gelfoam sponge, was reflected on the anterior cranial base/orbital roof. The postoperative course was uneventful; magnetic resonance imaging depicted resolution of proptosis. Histological examination favored parasinusal osteoma associated with intracranial mucocele, frontal bone hyperostosis, and inflammatory pseudotumor.
鼻窦骨瘤并发颅内和眶内延伸、颅盖骨过度增生、颅内黏液囊肿和炎性假瘤较为罕见。一名 68 岁男性，左眼进行性眼球突出和复发性角膜炎病史较长，伴有上视受限。增强磁共振成像显示额窦病变延伸至左前颅窝和眼眶，具有颅内囊性成分和不均匀的对比增强。头部计算机断层扫描证实病变为双钙化-囊性。经眶上额部入路可完全切除黏液囊肿和钻除颅内和眶骨骨瘤，包括鼻窦内成分。额窦被颅化，并用明胶海绵加固的颅骨瓣被反射到颅前窝底/眶顶。术后过程顺利；磁共振成像显示眼球突出缓解。组织学检查提示鼻窦骨瘤伴颅内黏液囊肿、额骨过度增生和炎性假瘤。
