[Osteoma of the naso-sinusal cavities. Surgical indications and role of endonasal endoscopic surgery].

Osteoma of the para-nasal sinuses is a rare and benign tumor that develops slowly. When therapy becomes mandatory, it is necessarily surgical and requires a standard external approach. This report analyses seven cases of operated osteomas, using different surgical techniques, adapted to different indications. Three patients underwent exclusive endonasal endoscopic surgery, and four patients had external surgery coupled with endonasal surgery. Results have proven successful with a four-year median follow-up. Epidemiological, clinical, histological and therapeutic considerations as well as the value of the endoscopic endonasal surgical approach are discussed. Endonasal endoscopic surgery can be used alone in naso-ethmoidal osteomas. It must, though, be associated with external standard procedure when the osteoma involves important extension to the frontal sinuses. In isolated frontal osteomas, external standard approach is mandatory for resection, endonasal technique being in this case contributive to the repermeabilisation of the infundibulum.