Prizio Carmine, Achena Andrea, Lorenzi Andrea, Micolitti Carola, Accorona Remo, Pilolli Francesco, Maniaci Antonino, Mevio Niccolò, Dragonetti Alberto Giulio
Division of Otolaryngology, ASST Grande Ospedale Metropolitano Niguarda, 3 Piazza Ospedale Maggiore, Milan, 20162, Italy.
Division of Otolaryngology, Department of Surgical Sciences, University of Turin, Turin, Italy.
Eur Arch Otorhinolaryngol. 2025 May;282(5):2419-2427. doi: 10.1007/s00405-025-09331-x. Epub 2025 Mar 28.
Frontal sinus osteomas are benign tumors that often require surgical resection due to their proximity to critical anatomical structures. The surgical approach can vary significantly depending on the size, location, and extent of involvement of these structures. Currently, no universally accepted classification system exists to guide the surgical management of frontal sinus osteomas. This study proposes a classification system based on these factors, with the objective of providing a standardized approach for selecting the most appropriate surgical techniques.
A retrospective analysis was conducted on all patients who underwent surgical resection of frontal sinus osteomas at a single institution from 2012 to 2024. Osteomas were categorized into three grades (I, II, and III) based on size, location, and anatomical features. Surgical outcomes were analyzed in relation to the osteoma classification.
Fifty-two patients were included in the study. Of these, 41 (78.8%) patients were treated using an endoscopic approach, 7 (13.5%) with an open approach, and 4 (7.7%) with a combined approach. According to the classification, 25 (48.1%) osteomas were categorized as grade I, 14 (26.9%) as grade II, 13 (25.0%) as grade III. Grade I osteomas were predominantly managed with endoscopic techniques, while grade II osteomas required extended endoscopic approaches. Grade III necessitated open or combined approaches.
This classification system provides a structured approach for determining the optimal surgical method for frontal sinus osteomas, aiming to reduce variability in treatment and improve patient outcomes.
额窦骨瘤是良性肿瘤，由于其靠近关键解剖结构，常需手术切除。手术方式会因这些结构的大小、位置及受累范围而有显著差异。目前，尚无普遍接受的分类系统来指导额窦骨瘤的手术治疗。本研究基于这些因素提出一种分类系统，目的是为选择最合适的手术技术提供标准化方法。
对2012年至2024年在单一机构接受额窦骨瘤手术切除的所有患者进行回顾性分析。根据大小、位置和解剖特征将骨瘤分为三个等级（I、II和III级）。分析手术结果与骨瘤分类之间的关系。
52例患者纳入研究。其中，41例（78.8%）患者采用内镜手术方法治疗，7例（13.5%）采用开放手术，4例（7.7%）采用联合手术。根据分类，25例（48.1%）骨瘤为I级，14例（26.9%）为II级，13例（25.0%）为III级。I级骨瘤主要采用内镜技术处理，II级骨瘤需要扩展内镜手术方法。III级骨瘤需要开放或联合手术方法。
该分类系统为确定额窦骨瘤的最佳手术方法提供了一种结构化方法，旨在减少治疗的变异性并改善患者预后。
