Otolaryngology Head and Neck Surgery Department, Addis Ababa University, Addis Ababa, Ethiopia.
Mekelle University, Mekelle, Ethiopia.
J Med Case Rep. 2024 Nov 29;18(1):584. doi: 10.1186/s13256-024-04953-x.
Osteomas are the most common benign tumors of the sinonasal region. Often asymptomatic, they are frequently discovered incidentally during imaging studies conducted for unrelated conditions. Osteomas typically range in size from 2 to 30 mm; those larger than 30 mm or weighing more than 110 g are classified as "big" or "giant" osteomas. Giant osteomas of the paranasal sinuses are extremely rare and can extend into the intraorbital or cerebral space, leading to significant complications. When osteomas become symptomatic, the standard treatment is surgical intervention to alleviate associated issues and prevent further progression.
This report discusses a case of a giant fronto-ethmoidal osteoma (45 × 42 mm) with intracranial and orbital extension, focusing on the clinical presentation, diagnostic process, and surgical management. We present the case of a 30-year-old Black female patient from Addis Ababa, Ethiopia, with a fronto-ethmoidal osteoma causing compression of the ocular globe and the left frontal lobe. Given the intracranial extension, a combined surgical team consisting of an ENT surgeon and a neurosurgeon was assembled to address the case. The surgery was performed via an external and lateral rhinotomy with a Lynch extension approach, aiming for complete resection of the osteoma originating from the frontal sinus and extending into the orbit and intracranial space.
Giant sinonasal osteomas are rare tumors. The primary goal of treatment is to completely remove the tumor using a combined endoscopic and external approach. Postoperative morbidity varies depending on the surgical technique used, and there is a risk of recurrence if the tumor is not entirely excised.
骨瘤是鼻窦区域最常见的良性肿瘤。它们通常无症状，在因其他原因进行的影像学检查中经常被偶然发现。骨瘤大小通常在 2 至 30 毫米之间；大于 30 毫米或重量超过 110 克的被归类为“大”或“巨大”骨瘤。鼻窦巨大骨瘤极为罕见，可延伸至眼眶或颅内空间，导致严重并发症。当骨瘤出现症状时，标准治疗方法是手术干预，以缓解相关问题并防止进一步进展。
本报告讨论了一例巨大额筛骨骨瘤（45×42 毫米）伴颅内和眼眶延伸的病例，重点介绍了临床表现、诊断过程和手术管理。我们介绍了一位来自埃塞俄比亚亚的斯亚贝巴的 30 岁黑人女性患者的病例，她患有额筛骨骨瘤，导致眼球和左额叶受压。由于颅内延伸，我们组建了一个由耳鼻喉科医生和神经外科医生组成的联合手术团队来处理该病例。手术通过外部和外侧鼻切开术以及 Lynch 延长入路进行，旨在完全切除起源于额窦并延伸至眼眶和颅内空间的骨瘤。
巨大的鼻窦骨瘤是罕见的肿瘤。治疗的主要目标是使用联合内镜和外部方法完全切除肿瘤。术后发病率取决于所使用的手术技术，并且如果肿瘤未完全切除，则有复发的风险。
