1
|
Dewantoro D, Cooper F, Ram B, Vallamkondu V. Endoscopically managed giant frontoethmoidal osteoma with orbital extension. BMJ Case Rep 2024; 17:e259236. [PMID: 38926120 DOI: 10.1136/bcr-2023-259236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024] Open
Abstract
A patient in his 20s presented with a change in the appearance of his left eye with evidence of relative afferent pupillary defect. Imaging revealed a giant frontoethmoidal osteoma, a benign sinonasal tumour, invading three-quarters of the orbit. Multidisciplinary discussion involving opthalmology, maxillofacial surgery, neurosurgery and otolaryngology resulted in the decision to attempt entirely endoscopic excision of this lesion, which was performed with successful outcomes. This case demonstrates how a sinonasal osteoma should be considered in the differential diagnosis for a patient presenting with proptosis or other eye signs suggestive of compression of the orbital compartment. This case report and literature review highlights the possibility of managing giant sinonasal osteomas with orbital extension through a completely endoscopic approach.
Collapse
Affiliation(s)
| | - Fergus Cooper
- Department of Otolaryngology, NHS Grampian, Aberdeen, UK
| | - Bhaskar Ram
- Department of Otolaryngology, NHS Grampian, Aberdeen, UK
| | | |
Collapse
|
2
|
Alareek L, Alsuhaibani A, Malika R, Bahabri S, Alsaleh S. Ethmoid Osteoblastoma: A Case Report and Pooled Analysis of Cases. EAR, NOSE & THROAT JOURNAL 2024:1455613241244659. [PMID: 38624092 DOI: 10.1177/01455613241244659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024] Open
Abstract
Osteoblastoma is a typically noncancerous bone tumor commonly found in the spine and long bones of the arms and legs. It is exceedingly rare for this tumor to occur in the paranasal sinuses. We present a case of osteoblastoma in a 13-year-old boy affecting the ethmoid sinus, which manifested as exophthalmos. A computed tomography scan revealed an expansive lesion in the right ethmoid sinus, causing compression and displacement of the orbital contents to the right. The lesion exhibited a mix of ground glass opacity and dense bone. On magnetic resonance imaging, the less dense areas of the tumor showed strong enhancement, while the densely sclerotic regions appeared as signal voids on all imaging sequences. A combined transorbital and transnasal approach was performed to remove the tumor. Histologically, the tumor consisted expansile growth surrounded by a sclerotic rim of inter-anastomosing trabeculae of woven bone set within loose edematous fibrovascular stroma. This case highlights the unusual occurrence of osteoblastoma in the ethmoid sinus, a location seldom associated with this type of tumor, and adds to the existing literature on this topic and offers a new surgical approach to managing this entity.
Collapse
Affiliation(s)
- Latefa Alareek
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Adel Alsuhaibani
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Rawan Malika
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saeed Bahabri
- Pathology Department and Medical Laboratories, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Saad Alsaleh
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
3
|
Sagar M, Dharmavaram Rajasekhar P, Singh CA, Khandkar H. Juvenile trabecular ossifying fibroma of the inferior turbinate. BMJ Case Rep 2024; 17:e259397. [PMID: 38627043 PMCID: PMC11029416 DOI: 10.1136/bcr-2023-259397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
Nasal obstruction is a commonly reported issue in the Otorhinolaryngology Outpatient Department. In this case, an early adolescent boy with a long-standing problem of right-sided nasal obstruction since childhood sought consultation. Diagnostic nasal endoscopy revealed a deviation of the nasal septum to the left, coupled with right inferior turbinate hypertrophy, all overlying healthy mucosa. A CT scan of the nose and paranasal sinuses further identified a bony hyperdense lesion with ground glass attenuation, confined to the right inferior turbinate. Subsequent biopsy confirmed juvenile trabecular ossifying fibroma (JTOF). The patient underwent endoscopic right medial maxillectomy, and the final histology affirmed the diagnosis of JTOF.
Collapse
Affiliation(s)
- Milind Sagar
- ENT, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | | | - Chirom Amit Singh
- Department of Otorhinolaryngology and Head-Neck Surgery, AIIMS, New Delhi, Delhi, India
| | - Hena Khandkar
- Department of Pathology, AIIMS, New Delhi, Delhi, India
| |
Collapse
|
4
|
Thomas AS, Trupthi MC, Ponmar M, Issac R. Misdiagnosed long-standing unilateral nasal obstruction: ossifying fibroma of the inferior turbinate. BMJ Case Rep 2024; 17:e255881. [PMID: 38199659 PMCID: PMC10806964 DOI: 10.1136/bcr-2023-255881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Abstract
A man in his 20s presented with complaints of unilateral nasal obstruction for the past 6 years that progressively worsened leading to irrational use of over-the-counter nasal decongestants. With the worsening of symptoms, a non-contrast CT was done. It showed a dense expansile sclerotic lesion of the right inferior turbinate, which was excised endoscopically. Cemento-ossifying fibromas of the inferior turbinate are rare and require assessment and surgical excision to relieve the symptom of nasal obstruction. It derives its name from the variable proportions of fibrous and mineralised tissue present in it and exclusively develops in the craniofacial region. It can be surgically managed by an endoscopic, an endonasal non-endoscopic (with a speculum) or an open approach (lateral rhinotomy, sublabial approach or mid-facial degloving). Here, we present how such a case was detected and managed surgically by the endoscopic approach, which is a minimally invasive option with shorter hospital stay and early recovery.
Collapse
Affiliation(s)
- Akhila Sarah Thomas
- Department of ENT, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Menuskodige C Trupthi
- Department of ENT, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Madhurima Ponmar
- Department of General Pathology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Rijo Issac
- Department of General Pathology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| |
Collapse
|
5
|
Nagornaya N, Saigal G, Bhatia R. Malignant and Nonmalignant Sinonasal Tumors. Oral Maxillofac Surg Clin North Am 2023:S1042-3699(23)00026-2. [PMID: 37149426 DOI: 10.1016/j.coms.2023.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Sinonasal tumors are rare, diverse, complex lesions with overlapping demographic and clinical features. Malignant tumors are more common, with a grave prognosis, and require biopsy for accurate diagnosis. This article briefly reviews the classification of sinonasal tumors and provides imaging examples and imaging characteristics of each clinically important nasal and paranasal mass lesions. Although there are no true pathognomonic imaging features, it is important for the radiologist to have a broad knowledge of the various CT and MR imaging findings that can help narrow the differential diagnosis and aid in early diagnosis and mapping of tumor for treatment planning.
Collapse
Affiliation(s)
- Natalya Nagornaya
- Department of Radiology, University of Miami Miller School of Medicine, Jackson Memorial Hospital, 1611 NW12th Avenue, WW- 279, Miami, FL 33136, USA.
| | - Gaurav Saigal
- Department of Radiology, University of Miami Miller School of Medicine, Jackson Memorial Hospital, 1611 NW12th Avenue, WW- 279, Miami, FL 33136, USA
| | - Rita Bhatia
- Department of Radiology, University of Miami Miller School of Medicine, Jackson Memorial Hospital, 1611 NW12th Avenue, WW- 279, Miami, FL 33136, USA
| |
Collapse
|
6
|
Supsupin EP, Gonzales NS, Debnam JM. Anatomy and Pathology of the Skull Base: Malignant and Nonmalignant Lesions. Oral Maxillofac Surg Clin North Am 2023:S1042-3699(23)00025-0. [PMID: 37142448 DOI: 10.1016/j.coms.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The skull base (SB) is the osseous foundation of the cranial vault. It contains many openings that allow communication between the extracranial and intracranial structures. This communication is crucial in normal physiologic processes yet may also arrow spread of disease. This article provides a comprehensive review of SB anatomy including important landmarks and anatomic variants relevant to SB surgery. We also illustrate the diverse pathologies affecting the SB.
Collapse
Affiliation(s)
- Emilio P Supsupin
- Radiology/Neuroradiology, Radiology Residency Program, University of Florida College of Medicine, 655 West 8th. Street, Jacksonville, FL 32209, USA.
| | - Noelani S Gonzales
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL 33314, USA
| | - James Matthew Debnam
- Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| |
Collapse
|
7
|
Acharya V, Ng J, Navaratnam A, Rennie C, Clarke P. A novel technique to repair orbital roof defects: irradiated homologous cadaveric rib (Tutoplast ®) graft in a recurrent frontal sinus ossifying fibroma. J Surg Case Rep 2022; 2022:rjac535. [PMCID: PMC9682098 DOI: 10.1093/jscr/rjac535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 10/31/2022] [Indexed: 11/24/2022] Open
Abstract
Ossifying fibroma in the fronto-ethmoidal sinuses is a rare, benign condition. In symptomatic cases, surgical excision is often undertaken and bony defects may be repaired using alloplastic grafts. We present a novel method of repairing an orbital roof defect using irradiated homologous cadaveric rib (Tutoplast ®) graft, overlaid with a pericranial flap. The patient made an excellent recovery, concluding that it is a viable and safe option with lower morbidity.
Collapse
Affiliation(s)
- Vikas Acharya
- Correspondence address. Department of ENT Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London W6 RF, UK. Tel: 020 3311 1234; Fax: 020 3311 1234; E-mail:
| | - Jimmy Ng
- Department of ENT Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London W6 RF, UK
| | - Annakan Navaratnam
- Department of ENT Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London W6 RF, UK
| | - Catherine Rennie
- Department of ENT Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London W6 RF, UK
| | - Peter Clarke
- Department of ENT Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London W6 RF, UK
| |
Collapse
|
8
|
Lee DH, Lim SC. Long-Term Results of Fibrous Dysplasia of the Paranasal Sinuses. J Craniofac Surg 2022; 33:e699-e701. [PMID: 35240670 DOI: 10.1097/scs.0000000000008601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/07/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Fibrous dysplasia (FD) is a benign, idiopathic skeletal disorder, in which the normal bone and marrow are replaced by fibrous tissue and immature woven bone. The authors aim to analyze the long-term results of patients diagnosed with FD of the paranasal sinuses via imaging or surgical biopsy. METHODS The authors retrospectively enrolled 21 patients with FD of the paranasal sinuses from 2006 to 2021. RESULTS The mean age at the time of diagnosis of FD of the paranasal sinuses was very high at 45.9 years. The most common site ofoccurrence was the sphenoid sinus (71.4%). During the mean follow-up period of 52.8 months, there was no significant change in the size of FD of the paranasal sinuses, and there was no worsening of symptoms or complications. Endoscopic sinus surgery was performed in 16 patients (76.2%), of which 13 underwent only biopsy and 3 underwent partial resection. CONCLUSIONS The most common site of FD of the paranasal sinuses was the sphenoid sinus, and the age at diagnosis was higher thanthat of patients with FD at other sites. Observation with serial radiologic examinations is recommended for asymptomatic FD of the para-nasal sinuses.
Collapse
Affiliation(s)
- Dong Hoon Lee
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Hwasun Hospital, Hwasun, South Korea
| | | |
Collapse
|
9
|
Gima E, Qamil S, Izzati A, Ismail F, Md Shukri N. Endoscopic Excision of Frontal Recess Osteoma in a Patient With Nasal Polyposis. Cureus 2022; 14:e28362. [PMID: 36168336 PMCID: PMC9508323 DOI: 10.7759/cureus.28362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2022] [Indexed: 11/05/2022] Open
Abstract
Paranasal sinus (PNS) osteomas are benign growths that are usually asymptomatic and often discovered incidentally upon imaging. Nasal polyps, on the other hand, are relatively commoner than osteomas. With the adoption of endoscopic technology in the otorhinolaryngology (ORL) field, surgeons are shifting toward less invasive surgical methods in managing such cases. We present a case of a 23-year-old male who had chronic rhinosinusitis with nasal polyps. A computed tomography (CT) done as part of his preoperative planning revealed findings suggestive of nasal polyps with left frontal recess osteoma. Both pathologies were removed successfully via an endoscopic endonasal approach.
Collapse
|
10
|
Magboul NA, Al-Ahmari MS, Alzahrani MA, Dlboh SS. Fibro-Osseous Lesion of the Nose and Paranasal Sinus: A Retrospective Study With Literature Review. Cureus 2022; 14:e27229. [PMID: 36035031 PMCID: PMC9399665 DOI: 10.7759/cureus.27229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/06/2022] Open
Abstract
Background Fibro-osseous (FO) lesions are slow-growing benign lesions in the paranasal sinuses. They include osteomas, fibrous dysplasia (FD), and ossifying fibroma (OF). Fibro-osseous (FO) lesions are frequently asymptomatic, and they are incidentally found on imaging. They are characterized by different histological, radiological, and clinical variants. Depending on symptoms, size, location, and extension, the treatment strategy varies significantly for these lesions. Objective We aim to compare the age, onset, gender, clinical presentation, postoperative improvement, and complications of a fibro-osseous lesion in the paranasal sinuses. Methods A retrospective analysis was done targeting patients diagnosed with benign fibro-osseous (FO) lesions, and the incidence among 403 patients who underwent functional endoscopic sinus surgery (FESS) at Aseer Central Hospital, Kingdom of Saudi Arabia, was reviewed from January 2013 to January 2022. Results A total of seven patients were found; five patients were diagnosed with osteoma, and two were diagnosed with fibrous dysplasia. There were no ossifying fibroma cases. The patients’ mean age was 25.5 ± 12.9 years old. Four (57.1%) patients were males, and three (42.9%) were females, with a male/female ratio of 1.25:1. The most common locations were the frontal sinus and ethmoid sinus, and the two cases of fibrous dysplasia involved almost all facial bones. The endonasal endoscopic approach was chosen to treat all seven patients. Conclusions There are differences in the onset age, location, and complications postoperatively among osteoma and fibrous dysplasia patients. Osteoma most commonly occurs in the frontal sinus, while fibrous dysplasia involved all facial bones in our study. Endoscopic surgery is currently the primary strategy for treatment.
Collapse
|
11
|
Aggressive juvenile ossifying fibroma of the ethmoid sinus with orbital and intracranial extension: A case report. Int J Surg Case Rep 2022; 96:107255. [PMID: 35738137 PMCID: PMC9218808 DOI: 10.1016/j.ijscr.2022.107255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/22/2022] [Accepted: 05/28/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Juvenile ossifying fibroma is a rare benign destructive lesion of nose and paranasal sinuses. It occurs in the craniofacial bones of children below 15 years of age. It is usually discovered in the mandible and maxilla and rarely in the paranasal sinuses. CASE PRESENTATION We present a case of a 15-year-old girl with extensive right ethmoid sinus juvenile ossifying fibroma with intracranial and orbital involvement that was managed endoscopically at our center followed by lateral rhinotomy and frontal craniotomy with reconstruction due to the aggressive nature and recurrence of the disease. Patient was followed up post operatively for 3 years and was found free of symptoms ever since. CONCLUSION In this case report we present our experience in managing this aggressive recurrent disease of juvenile ossifying fibroma which requires multiple endoscopic and open surgical procedures. Such pathology needs a close and long follow up due to the aggressive nature of this disease.
Collapse
|
12
|
Lambdoid Craniosynostosis in an Infant with Congenital Cystic Adenomatoid Malformation (CCAM). J Craniofac Surg 2022; 33:e696-e699. [PMID: 35240670 DOI: 10.1097/scs.0000000000008605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/08/2022] [Indexed: 10/18/2022] Open
Abstract
ABSTRACT Both congenital cystic adenomatoid malformation (CCAM) and lambdoid craniosynostosis are exceedingly rare, with estimated incidences of around 1 in 30,000 live births for each. Herein, we present a case of a patient with prenatally diagnosed CCAM requiring 4 doses of prenatal steroids and ultimately thoracotomy with right lower lobectomy. The operation was uncomplicated, and genome-wide analysis of SNPs revealed no pathologic abnormalities. Development was normal until head shape changes were noted at 5 months of age at which point evaluation by a craniofacial surgeon and 3D CT imaging revealed left-sided lambdoid craniosynostosis. The patient underwent uncomplicated posterior and middle vault expansion and remodeling of his lambdoid synostosis at 11 months of age. This paper explores the etiopathogenesis of CCAM and lambdoid craniosynostosis in an attempt to identify common pathways involved in the development of these exceedingly rare diseases which, to date, have not been described in the peer-reviewed literature.
Collapse
|
13
|
Almomen A, Alshuhayb Z, Alsheef H, Alhammad S, Alawami B, Aldhurais A, Almulla H, Almoumen Z, Alkishi S. The Endoscopic Management of Different Pediatric Frontal Sinus Pathologies. Int J Otolaryngol 2022; 2022:1078178. [PMID: 35186090 PMCID: PMC8853819 DOI: 10.1155/2022/1078178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 12/23/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The paranasal sinuses in pediatrics can harbor a wide variety of pathologies. With the present literature being composed of case studies only, this entity is quite understudied. OBJECTIVES This article aims to study the clinical presentation, diagnosis, and endoscopic management of six different rare frontal sinus pathologies in pediatrics, which include extensive allergic fungal sinusitis, mucoceles, osteoma, superior sagittal sinus thrombosis, CSF leak, and subdural empyema. METHODS We retrospectively studied all pediatric patients with frontal sinus pathologies presenting to our center, King Fahad Specialist Hospital, Dammam, Saudi Arabia, from the period of 2006 to 2020. RESULTS A total of 8 patients presented to our hospital with different frontal sinus pathologies. 5 of them were males, and 3 were females with an age of presentation ranging from 7 to 17 years. The diagnosis and localization were performed through computerized tomography without contrast and magnetic resonance imaging, when indicated. All cases were primarily managed with endonasal endoscopic approaches successfully without complications and with no recurrence evident upon follow-up. CONCLUSION In this case series, six different frontal sinus pathologies were managed by an endoscopic approach, with excellent recovery and no recurrence upon follow-up demonstrated. This approach enabled excellent visualization of the pathologies, accurate localization, adequate drainage, and repair or grafting when needed.
Collapse
Affiliation(s)
- Ali Almomen
- King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Ectopic Laryngeal Ossification after Bone Morphogenetic Protein-2. SURGERIES 2021; 2:384-390. [PMID: 35463995 PMCID: PMC9030225 DOI: 10.3390/surgeries2040038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We report two cases of ectopic bone formation in the head and neck following treatment with recombinant human bone morphogenetic protein-2 (rhBMP-2). Surgical pathologic data, laryngoscopy imaging, CT imaging, and patient medical history were obtained. First, we report osseous metaplasia in the vocal fold in a 67-year-old male following mandibular dental implants with rhBMP-2; second, a case of severe bony overgrowth of the larynx and fusion to the anterior cervical spine (ACS) in a 73-year-old male following multiple anterior cervical discectomies and fusions with rhBMP-2. Ectopic bone formation following rhBMP-2 has been previously reported. Adverse events like local swelling and edema leading to dysphagia and even airway obstruction after cervical spine application of rhBMP-2 have also been widely reported. Due to the uncommon nature of abnormal bony growth in soft tissue areas of the head and neck and the previously documented adverse effects of rhBMP-2 use, especially in the cervical spine, we consider the two unusual case presentations of ectopic bony formation highly likely to be linked with rhBMP-2. We urge awareness of the adverse effects caused by rhBMP-2, and urge caution in dosing.
Collapse
|
15
|
Lentzen MP, Riekert M, Grozinger P, Zirk M, Nickenig HJ, Zöller JE, Kreppel M. Anatomical and volumetric analysis of fibro-osseous lesions of the craniofacial skeleton. J Craniomaxillofac Surg 2021; 49:1113-1118. [PMID: 34563422 DOI: 10.1016/j.jcms.2021.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 08/31/2021] [Accepted: 09/13/2021] [Indexed: 02/08/2023] Open
Abstract
PURPOSE Our study aimed to provide volumetric data relating to fibro-osseous lesions of the craniofacial skeleton, in order to highlight risk factors due to the different entities, and to guide clinical decisions for jeopardized patients. METHODS Volumetric measurements of osteomas and ossifying fibromas were performed by applying the open-source software ITK-Snap to cone-beam computed tomography images. DICOM datasets were imported, identified, and delineated using semiautomatic segmentation; this was then verified using manual segmentation. The volumes of the lesions were computed automatically in cubic millimeters using the program. For statistical investigations, descriptive statistics and independent Student t-tests were performed. Additionally, Pearson's correlation was applied as a bivariate analysis. Values of p < 0.05 were considered significant. RESULTS 45 patients (11 male and 34 female) were included in this study. The mean volumes were 10.02 ± 18.79 cm3 for osteomas and 4.80 ± 5.71 cm3 for ossifying fibromas (p = 0.016). Males (12.81 ± 20.38 cm3) presented significantly larger volumes than females (5.43 ± 10.32 cm3) (p = 0.042). With regard to shape, morphology, and affection of surrounding anatomical structures, irregular shape (p = 0.001; p = 0.037), multilocular morphology (p = 0.001; p = 0.037), nerve affection (p = 0.001; p = 0.002), tooth affection (p = 0.001; p = 0.594), cortical bone exceedance (p = 0.033; p = 0.001), and clinically visible symptoms (p = 0.004; p = 0.001) were statistically significantly associated with a larger volume of both entities. CONCLUSION Volumetric analysis revealed that osteomas significantly exceeded the mean size of ossifying fibromas, supporting the argument that special attention should be paid to this entity. In cases of difficult histopathological examination, lesions with irregular shape, multilocular morphology, nerve and tooth affection, cortical bone exceedance, and clinically visible symptoms should be considered for close clinico-radiological follow-up, irrespective of the entity.
Collapse
Affiliation(s)
- Max-Philipp Lentzen
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University Hospital Cologne and Faculty of Medicine, University of Cologne, Germany.
| | - Maximilian Riekert
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University Hospital Cologne and Faculty of Medicine, University of Cologne, Germany
| | - Philipp Grozinger
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University Hospital Cologne and Faculty of Medicine, University of Cologne, Germany
| | - Matthias Zirk
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University Hospital Cologne and Faculty of Medicine, University of Cologne, Germany
| | - Hans-Joachim Nickenig
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University Hospital Cologne and Faculty of Medicine, University of Cologne, Germany
| | - Joachim E Zöller
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University Hospital Cologne and Faculty of Medicine, University of Cologne, Germany
| | - Matthias Kreppel
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University Hospital Cologne and Faculty of Medicine, University of Cologne, Germany
| |
Collapse
|
16
|
Sommer F. Rare Diseases of the Nose, the Paranasal Sinuses, and the Anterior Skull Base. Laryngorhinootologie 2021; 100:S1-S44. [PMID: 34352902 PMCID: PMC8354577 DOI: 10.1055/a-1331-2469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Due to their low incidence and thus resulting limited diagnostic criteria as well as therapeutic options, rare diseases of the nose, the paranasal sinuses, and the anterior skull base are a significant challenge. The value as of which a disease has to be considered as rare amounts to a maximum of 5 patients per 10 000 people. Within these diseases, however, there are extreme differences. Some rare or orphan diseases like for example the inverted papilloma belong to regularly diagnosed and treated diseases of larger departments of oto-rhino-laryngology whereas other rare diseases and malformations have only been described in less than 100 case reports worldwide. This fact emphasizes the necessity of bundling the available experience of diagnostics and therapy. The present article gives an overview about rare diseases of the nose, the paranasal sinuses, and the anterior skull base from the field of diseases/syndromes of the olfactory system, malformations of the nose and paranasal sinuses, ventilation and functional disorders as well as benign and malignant tumors. The classification and data on diagnostic and therapeutic options were established based on the current literature.
Collapse
Affiliation(s)
- Fabian Sommer
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Hals-Chirurgie, Universitätsklinik Ulm
| |
Collapse
|
17
|
Fibrous Dysplasia-like Lacrimal Sac Tumor Associated With Dacryocystitis. Ophthalmic Plast Reconstr Surg 2021; 36:e23-e24. [PMID: 31895726 DOI: 10.1097/iop.0000000000001526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A 72-year-old woman who presented with right-sided epiphora and conjunctivitis underwent a probing and irrigation procedure with normal results. She improved with antibiotic-steroid drops. A swelling in the medial canthal region completely resolved. One year later, she returned with symptoms of dacryocystitis. An external dacryocystorhinostomy was performed. Characteristic dacryoliths were removed from the sac lumen, and biopsy of the sac wall showed spicules of lamellar bone within a fibrous stroma. Diagnosed as fibrous dysplasia of the lacrimal sac, this rare entity represents the second such case in the literature.The histopathology of an ossified lacrimal sac resembled fibrous dysplasia of bone and exemplifies the second case of this rare entity in the literature.
Collapse
|
18
|
Hemachandran N, Sharma S. Sinonasal Diseases Affecting the Orbit - A Radiological Pattern-Based Approach. Curr Probl Diagn Radiol 2020; 50:505-511. [PMID: 32828604 DOI: 10.1067/j.cpradiol.2020.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/04/2020] [Accepted: 07/20/2020] [Indexed: 11/22/2022]
Abstract
The orbit is surrounded on three sides by paranasal sinuses with only a thin rim of bone separating the 2 at each site, predisposing it to the risk of being affected by the diseases of primary sinonasal compartment. A wide range of sinonasal pathologies can show orbital involvement and may present mainly with orbital symptoms. While most of these are due to contiguous involvement, a few others may be caused by systemic diseases that often involve both, the orbit and the sinuses in a noncontiguous manner. In this article, we have classified these diseases based on their radiological appearances into 5 patterns: Pattern 1 - Fat stranding predominant, Pattern 2 - Soft tissue without bone destruction, Pattern 3 - Soft tissue with bone destruction, Pattern 4 - Bony pathologies, Pattern 5 - Sinus volume changes. Various pathologies have been classified into these patterns considering the most typical changes in each of the disease processes. We briefly review these patterns, their hallmark radiological signs, typical examples of each pattern as well as review the various diseases process highlighting their radiological appearances. Imaging plays a crucial role in identifying the epicentre of the disease process, narrowing down the differential diagnoses, identifying management modifying complications, planning the surgical management as well as in the follow up of several such lesions. This unique radiological approach, although not absolute, aims to provide a new insight and working algorithm to help narrowing down the differential diagnoses.
Collapse
Affiliation(s)
| | - Sanjay Sharma
- Department of Radiodiagnosis, AIIMS, New Delhi, India.
| |
Collapse
|
19
|
Abstract
This case report describes a rare presentation of an osteoma in the maxillary sinus picked up from an incidental finding on an orthopantomogram that was obtained to inform orthodontic treatment. While orthodontists principally use this radiograph to assess the developing dentition, aid treatment planning and monitor treatment, several peripheral anatomical sites are evident on this radiograph. We review the literature in relation to osteomas presenting in the craniofacial area along with its management. We provide examples of common radiopaque lesions along with their radiographic features that dental healthcare clinicians may encounter.
Collapse
Affiliation(s)
| | - Mohammad Owaise Sharif
- Eastman Dental Hospital, London, UK
- University College London, Eastman Dental Institute, London, UK
| |
Collapse
|
20
|
Wang EW, Zanation AM, Gardner PA, Schwartz TH, Eloy JA, Adappa ND, Bettag M, Bleier BS, Cappabianca P, Carrau RL, Casiano RR, Cavallo LM, Ebert CS, El-Sayed IH, Evans JJ, Fernandez-Miranda JC, Folbe AJ, Froelich S, Gentili F, Harvey RJ, Hwang PH, Jane JA, Kelly DF, Kennedy D, Knosp E, Lal D, Lee JYK, Liu JK, Lund VJ, Palmer JN, Prevedello DM, Schlosser RJ, Sindwani R, Solares CA, Tabaee A, Teo C, Thirumala PD, Thorp BD, de Arnaldo Silva Vellutini E, Witterick I, Woodworth BA, Wormald PJ, Snyderman CH. ICAR: endoscopic skull-base surgery. Int Forum Allergy Rhinol 2020; 9:S145-S365. [PMID: 31329374 DOI: 10.1002/alr.22326] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 02/12/2019] [Accepted: 02/15/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Endoscopic skull-base surgery (ESBS) is employed in the management of diverse skull-base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull-base surgery have produced the International Consensus Statement on Endoscopic Skull-Base Surgery (ICAR:ESBS). METHODS Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence-based review or evidence-based review with recommendations format. Subsequently, each topic was written and then reviewed by skull-base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. RESULTS The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull-base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. CONCLUSION A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence-based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull-base community to embrace these opportunities and collaboratively address these shortcomings.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Adam J Folbe
- Michigan Sinus and Skull Base Institute, Royal Oak, MI
| | | | | | - Richard J Harvey
- University of Toronto, Toronto, Canada.,University of New South Wales, Sydney, Australia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Charles Teo
- Prince of Wales Hospital, Randwick, Australia
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Abstract
Frontal sinus osteomas are benign bone-forming neoplasms. Ongoing advancements in endoscopic surgery have allowed less invasive surgical approaches to be adopted for removal. The authors systematically reviewed the literature to provide analysis and recommendations for management.One hundred ninety-three publications encompassing 1399 patients met inclusion, with mean age 42.1 ± 13.8 years and a male predominance (59.2%). Symptoms included pain (70.8%); orbital/ocular (20.7%); sinonasal (36.4%); neurologic (6.0%); other (14.5%); and asymptomatic (4.8%). Osteoma was isolated to the frontal sinus (82.9%) or extended into the ethmoid (16.6%), maxillary (0.3%), and sphenoid sinuses (0.2%). There was intracranial extension in 9.5% and intraorbital extension in 18.7%. Of those proceeding to surgery, majority (59.8%) underwent open approaches, followed by endoscopic (25.0%) and combined (11.5%). A significant (P < 0.01) increase in proportion of cases utilizing endoscopic approaches versus open/combined was observed over the period studied. Seventy-one postoperative complications were reported, in 7.5% of endoscopic cases, 27% of open, and 8.8% of combined. Complications were more likely in open/combined surgery, compared with endoscopic (22.3% versus 7.5%, P < 0.001). In 181 patients, completeness of resection was reported (complete resection; 87.8%) and found to be a significant predictor (P < 0.01) for disease recurrence/progression. Mean length of stay for the endoscopic group was 3.1 ± 1.3 days, compared with 7.9 ± 3.1 for open/combined (P < 0.0001).In the management of frontal sinus osteoma, indications for selecting endoscopic versus open approaches have expanded over the past 30 years, as techniques, equipment, and understanding of pathophysiology have evolved. Where endoscopic approaches are possible, they are associated with reduced morbidity and length of stay compared with open approaches.
Collapse
|
22
|
Wolf A, Safran B, Pock J, Tomazic PV, Stammberger H. Surgical Treatment of Paranasal Sinus Osteomas: A Single Center Experience of 58 Cases. Laryngoscope 2019; 130:2105-2113. [PMID: 31520491 DOI: 10.1002/lary.28299] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 08/09/2019] [Accepted: 08/29/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Osteomas are osseous tumors that primarily occur at the skull, in particular the paranasal sinus system. Surgical tumor resection is the "gold standard" treatment in symptomatic osteomas. The aim of this study was to investigate the use of surgical approaches (endoscopic, open, combined) and to provide a step-by-step approach for patients' management. METHODS Fifty-eight patients (31 m, 27 f, 42.1 ± 15.3 years) that were treated between 2001 and 2015 at our department were included in this retrospective, single center study. RESULTS In almost half of cases (n = 28, 48.3%) endoscopic, endonasal approaches were used for tumor resection while open (n = 11, 19%) or combined (n = 19, 32.8%) approaches were used in the rest of the cohort. Open or combined approaches were applied in patients suffering from osteomas localized in the maxillary or frontal sinuses only. CONCLUSION Beside interviews, clinical examination, nasal endoscopy, and computed tomography are crucial for diagnosis of paranasal sinus osteomas. Magnet resonance imaging can be useful in extensive pathologies. The preoperative selection of the optimal approach for osteoma resection might be most challenging in patients' management. Although useful recommendations regarding the use of surgical approaches have been published, technical requirements and surgical experience of surgeons have to be considered in the limitations of endoscopic approaches. If there are doubts about the resectability of an osteoma by an endoscopic approach, the surgical procedure may be started endoscopically, and, if necessary, it can be combined with an external approach. LEVEL OF EVIDENCE IV Laryngoscope, 130:2105-2113, 2020.
Collapse
Affiliation(s)
- Axel Wolf
- Department of General Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Graz, Austria
| | - Bettina Safran
- Department of General Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Graz, Austria
| | - Jakob Pock
- Department of General Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Graz, Austria
| | - Peter Valentin Tomazic
- Department of General Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Graz, Austria
| | - Heinz Stammberger
- Department of General Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Graz, Austria
| |
Collapse
|
23
|
Romano A, Dell'Aversana Orabona G, Pansini A, Abbate V, Cama A, Iaconetta G, Califano L. Endoscopic approach for paranasal sinuses osteomas: Our experience and review of literature. ORAL AND MAXILLOFACIAL SURGERY CASES 2019. [DOI: 10.1016/j.omsc.2019.100094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
24
|
Gan RWC, Gubbi G, Blackabey V, Ward VMM. Osteoma arising from the middle turbinate-a case series. AME Case Rep 2019; 3:17. [PMID: 31231718 DOI: 10.21037/acr.2019.05.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 05/08/2019] [Indexed: 11/06/2022]
Abstract
This case series aims to highlight that although extremely rare, osteoma can arise from the middle turbinate. We discuss the condition and treatment options. We describe 2 cases of osteomas arising from the middle turbinate. One occurring in a 29-year-old gentleman who presented to the ENT clinic with left nasal obstruction, and the other in a 65-year-old lady admitted to hospital with headaches and hypotension. Both cases were further investigated with CT scan. Both patients were treated with endoscopic fusion navigation assisted excision. Due to the large size of the mass, the gentleman required the mass to be delivered after it was drilled through and requiring septal deflection and vomerine spur reduction. As for the lady, the mass also required drilling and a posterior septotomy to facilitate dissection and removal of the tumour. Both patients made good recoveries with resolution of symptoms. Although extremely rare, osteomas can arise from the middle turbinate causing symptoms such as headache, facial pain, nasal obstruction and visual problems. As they are slow growing, they can be of large size at presentation. Treatment usually involves surgical excision. Endoscopic excision is usually adequate and safe.
Collapse
Affiliation(s)
- Richard Wei Chern Gan
- Department of Ear Nose & Throat, Pinderfields General Hospital, The Mid Yorkshire Hospitals NHS Trust, Wakefield WF1 4DG, UK
| | - Gayathri Gubbi
- Department of Ear Nose & Throat, Pinderfields General Hospital, The Mid Yorkshire Hospitals NHS Trust, Wakefield WF1 4DG, UK
| | - Victoria Blackabey
- Department of Ear Nose & Throat, Pinderfields General Hospital, The Mid Yorkshire Hospitals NHS Trust, Wakefield WF1 4DG, UK
| | - Victoria M M Ward
- Department of Ear Nose & Throat, Pinderfields General Hospital, The Mid Yorkshire Hospitals NHS Trust, Wakefield WF1 4DG, UK
| |
Collapse
|
25
|
Affiliation(s)
- Mohit Agarwal
- Department of Radiology, Division of Neuroradiology, Medical College of Wisconsin, Milwaukee, WI.
| | - Bruno Policeni
- Department of Radiology, Division of Neuroradiology, University of Iowa, Iowa City, IA
| |
Collapse
|
26
|
Imaging features of sinonasal tumors on positron emission tomography and magnetic resonance imaging including diffusion weighted imaging: A pictorial review. Clin Imaging 2018; 51:217-228. [DOI: 10.1016/j.clinimag.2018.05.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 05/17/2018] [Accepted: 05/24/2018] [Indexed: 11/19/2022]
|
27
|
Badran KW, Suh JD, Namiri N, Wrobel B, Ference EH. Pediatric Benign Paranasal Sinus Osteoneogenic Tumors: A Case Series and Systematic Review of Outcomes, Techniques, and a Multiportal Approach. Am J Rhinol Allergy 2018; 32:465-472. [PMID: 30132339 DOI: 10.1177/1945892418793475] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pediatric benign paranasal sinus osteoneogenic tumors have previously been difficult to treat due to the surgical constraints of the developing skull. Progression may lead to intracranial complications or orbital and optic nerve compression. OBJECTIVE To assess the presentation and management of benign paranasal sinus osteoneogenic tumors. METHODS Systematic review of the symptoms and surgical treatment of these lesions, and a case series of 2 adolescents with osteomas impinging on the orbit treated with a multiportal approach. RESULTS Forty-eight cases of osteomas, osteoblastoma, or osteoid osteomas were reviewed from 43 articles. The average age was 14 years, 67% of tumors were osteomas, and 48% were greater than 3 cm in longest dimension. Compared to osteoblastomas, osteomas had a greater male to female ratio (4.3:1; P = .02), presented at older age ( P = .03) with a smaller tumor burden ( P = .003), and had prior trauma or surgery ( P < .001). The ethmoid, frontal, maxillary, and sphenoid sinuses were affected in decreasing order of frequency. A purely endoscopic sinus surgery approach was taken in 31% of cases, open approach in 62% of cases, and combined approach in 7% of cases. Osteoblastoma patients had a 32% rate of recurrence, compared to only 3% among osteoma patients. On univariate logistics regression of patient demographics, tumor characteristics, and surgical approaches predictive of surgical outcomes, only tumor type was predictive of postoperative recurrence (odds ratio: 0.07; 95% confidence interval, 0.007-0.77; P = .029). CONCLUSION There was no association between surgical approach and postoperative complications or rate of recurrence. However, a transnasal and transorbital multiportal approach avoids facial incisions.
Collapse
Affiliation(s)
- Karam W Badran
- 1 Department of Otolaryngology-Head and Neck Surgery, David Geffen School of Medicine of the University of California, Los Angeles, California
| | - Jeffrey D Suh
- 1 Department of Otolaryngology-Head and Neck Surgery, David Geffen School of Medicine of the University of California, Los Angeles, California
| | - Nikan Namiri
- 2 Department of Bioengineering, University of California, Los Angeles, California
| | - Bozena Wrobel
- 3 Rick and Tina Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Elisabeth H Ference
- 3 Rick and Tina Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California
| |
Collapse
|
28
|
Dua SG, Locker PH, Rossi IR, Jandali D, Gattuso P, Batra PS, Tajudeen BA. Eccentric, mature osseous cap: A distinct imaging feature of sinonasal osteoblastoma. Am J Rhinol Allergy 2018; 32:82-84. [PMID: 29644901 DOI: 10.1177/1945892418762658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND With the exception of osteomas, bone neoplasms that originate in the sinonasal cavity are seldom diagnosed on preoperative imaging due to a lack of characteristic radiographic features. Here we described the unusual occurrence of an osteoblastoma in the paranasal sinuses, and we drew focus to its salient imaging features. A highly unique imaging sign was indicated, and its pathologic basis was explained, with concurrent review of the literature. METHODS Case series and review of the literature. RESULTS Two cases of sinonasal osteoblastoma were managed by definitive surgical resection. Both tumors on preoperative computed tomography demonstrated an expansile, heterogeneous fibro-osseous lesion with an eccentric, mature osseous cap. The dense osseous cap seen on imaging corresponded to a rim of mature bone on histopathology. A review of existing literature revealed the presence of this imaging sign in all reported cases. CONCLUSION Sinonasal osteoblastoma is an extremely rare entity with undefined imaging characteristics to guide preoperative decision-making. Here we reported, to our knowledge, the first description of a characteristic imaging sign of an eccentric, mature osseous cap, which corresponded histologically to a single peripheral layer rim of osteoblasts, a unique trait of osteoblastoma.
Collapse
Affiliation(s)
- Sumeet G Dua
- From the 1 Department of Radiology, Rush University Medical Center, Chicago, Illinois
| | - Philip H Locker
- 2 Rush Sinus Program, Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, and
| | - Isolina R Rossi
- 2 Rush Sinus Program, Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, and
| | - Danny Jandali
- 2 Rush Sinus Program, Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, and
| | - Paulo Gattuso
- 3 Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - Pete S Batra
- 2 Rush Sinus Program, Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, and
| | - Bobby A Tajudeen
- 2 Rush Sinus Program, Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, and
| |
Collapse
|
29
|
Lee YW, Kim YM. Antrochoanal polyp concomitant with turbinoethmoidal osteoma: A case report. Int J Surg Case Rep 2018; 43:1-3. [PMID: 29414499 PMCID: PMC5908385 DOI: 10.1016/j.ijscr.2018.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 12/22/2017] [Accepted: 01/13/2018] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Antrochoanal polyps (ACPs) have several unique features that distinguish them from other nasal polyps. Despite many investigations, the pathogenesis of ACP has not yet been elucidated. Sinonasal osteoma is the most common type of tumor of the sinonasal tract and can be caused by trauma, infection and developmental anomaly. PRESENTATION OF CASE We report the case of a 35-year-old man with left nasal obstruction for more than 20 years. Examination revealed ACP concomitant with an osteoma that arose from the middle turbinate and ethmoid sinus. The osteoma had an air cell in its anterosuperior area and was in a position of being pulled downward. The intranasal part of the ACP covered the posterior area of the osteoma. DISCUSSION Considering the radiological and surgical findings, the intranasal part of the ACP seems to have affected the turbinoethmoidal osteoma during its growth. CONCLUSION The authors describe a very rare condition in which an ACP was connected with a turbinoethmoidal osteoma.
Collapse
Affiliation(s)
- Yong Won Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Veterans Health Service, Daejeon Hospital, Daejeon, Republic of Korea.
| | - Yong Min Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University, School of Medicine, Daejeon, Republic of Korea
| |
Collapse
|
30
|
Duan C, Dai Q, Liu Q, Yu H. Characteristics of sinonasal fibrous dysplasia: experience from a single department. Acta Otolaryngol 2018; 138:50-55. [PMID: 28830313 DOI: 10.1080/00016489.2017.1367101] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES We summarized the characteristics of fibrous dysplasia patients in our department to obtain clinical data on this disease. METHODS We retrospectively reviewed 28 patients who were diagnosed with sinonasal fibrous dysplasia based on pathological examination results from March 2012 to February 2017 in our department. RESULTS The 28 patients included 16 females and 12 males, and the median age was 31.5 (range, 7-69) years. The three most common symptoms were nasal obstruction (25%), impaired vision (21%) and headache (18%). Most of the tumors were located in the sphenoid sinus (50%), nasal cavity (39%) or ethmoid sinus (36%). The surgical strategy included an exclusive endoscopic approach (25 cases) and an endoscopic approach combined with sublabial incision (three cases). The median follow-up period was 29 months (range, 3-62 months), and three patients were lost to follow-up. Two of the remaining 25 patients developed recurrence. However, since the second surgery, there has been no recurrence to date. CONCLUSIONS Our study indicates that the treatment of fibrous dysplasia patients should be tailored according to patient and disease characteristics. The main surgical procedure is the endoscopic approach, and the effect is good. Although the recurrence rate is low, follow-up is necessary.
Collapse
Affiliation(s)
- Chen Duan
- Department of Otolaryngology, Eye, Ear, Nose & Throat Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Fudan University, Shanghai, China
| | - Qi Dai
- Department of Otolaryngology, Eye, Ear, Nose & Throat Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Fudan University, Shanghai, China
| | - Quan Liu
- Department of Otolaryngology, Eye, Ear, Nose & Throat Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Fudan University, Shanghai, China
| | - Hongmeng Yu
- Department of Otolaryngology, Eye, Ear, Nose & Throat Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Fudan University, Shanghai, China
| |
Collapse
|
31
|
Ciniglio Appiani M, Verillaud B, Bresson D, Sauvaget E, Blancal JP, Guichard JP, Saint Maurice JP, Wassef M, Karligkiotis A, Kania R, Herman P. Ossifying fibromas of the paranasal sinuses: diagnosis and management. ACTA OTORHINOLARYNGOLOGICA ITALICA 2017; 35:355-61. [PMID: 26824919 PMCID: PMC4720932 DOI: 10.14639/0392-100x-533] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Fibro-osseous benign lesions rarely affect the sinonasal tract and are divided into 3 different entities, namely osteoma, fibrous dysplasia and ossifying fibroma. They share several clinical, radiological and histological similarities, but have different behaviours. Ossifying fibroma, and in particular the "juvenile" histological subtype, may have a locally aggressive evolution and a high risk for recurrence if removal is incomplete. The purpose of the present study is to compare the clinical behaviour of ossifying fibroma with the other benign fibro-osseous lesions; highlight different behaviour between the histological subtypes; compare the advantages, limitations and outcomes of an endoscopic endonasal approach with reports in the literature. We retrospectively reviewed 11 patients treated for sinonasal ossifying fibroma at a tertiary care centre. All patients underwent CT scan, and MRI was performed in cases of cranial base involvement or recurrence. Pre-operative biopsy was performed in cases where it was possible to use an endoscopic approach. One patient underwent pre-operative embolisation with ipsilateral visual loss after the procedure. Depending on its location, removal of the tumour was performed using an endoscopic (n = 7), or an external (n = 3) or combined (n = 1) approach. Histopathologically, 5 patients presented the conventional type, 5 the juvenile psammomatoid variant, which was associated in 1 case with an aneurismal bone cyst, and 1 case presented the trabecular juvenile variant. Three patients affected by the juvenile psammomatoid histological variant presented invasion of the skull base and underwent a subtotal removal that subsequently required, due to the regrowth of the remnant, a transbasal approach. Clinical, radiological and histological findings should all be considered to establish differential diagnosis among fibrous osseous lesions. More studies are necessary to conclude if the localisation and extension of the disease at the time of diagnosis is more important than the histological variant. An endoscopic approach is the first choice in most of cases even if an external open approach may be necessary in selected patients.
Collapse
Affiliation(s)
- M Ciniglio Appiani
- ENT Section, Department of Sensory Organs, Sapienza University of Rome, Italy
| | - B Verillaud
- ENT Department, Lariboisière Hospital, Assistance Publique, Hopitaux de Paris, Paris 7 University, Paris, France
| | - D Bresson
- Neurosurgery Department, Lariboisière Hospital, Assistance Publique, Hopitaux de Paris, Paris 7 University, Paris, France
| | - E Sauvaget
- ENT Department, Lariboisière Hospital, Assistance Publique, Hopitaux de Paris, Paris 7 University, Paris, France
| | - J-P Blancal
- ENT Department, Lariboisière Hospital, Assistance Publique, Hopitaux de Paris, Paris 7 University, Paris, France
| | - J-P Guichard
- Neuroradiology Department, Lariboisière Hospital, Assistance Publique, Hopitaux de Paris, Paris 7 University, Paris, France
| | - J-P Saint Maurice
- Neuroradiology Department, Lariboisière Hospital, Assistance Publique, Hopitaux de Paris, Paris 7 University, Paris, France
| | - M Wassef
- Pathology Department, Lariboisière Hospital, Assistance Publique, Hopitaux de Paris, Paris 7 University, Paris, France
| | - A Karligkiotis
- Division of Otorhinolaryngology, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Italy
| | - R Kania
- ENT Department, Lariboisière Hospital, Assistance Publique, Hopitaux de Paris, Paris 7 University, Paris, France
| | - P Herman
- ENT Department, Lariboisière Hospital, Assistance Publique, Hopitaux de Paris, Paris 7 University, Paris, France
| |
Collapse
|
32
|
Humeniuk-Arasiewicz M, Stryjewska-Makuch G, Janik MA, Kolebacz B. Giant fronto-ethmoidal osteoma - selection of an optimal surgical procedure. Braz J Otorhinolaryngol 2017; 84:232-239. [PMID: 28760714 PMCID: PMC9449161 DOI: 10.1016/j.bjorl.2017.06.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/18/2017] [Accepted: 06/21/2017] [Indexed: 11/18/2022] Open
Abstract
Introduction Osteomas of the paranasal sinuses are benign bone tumours that produce clinical signs depending on their size and location. In most reported cases large tumours are excised by an external approach or in conjunction with an endoscopic technique. Endoscopic treatment of such tumours is a huge challenge for the operator. Objective Determine the optimal surgical approach by analysing giant osteomas of the frontal and ethmoidal sinuses in the literature. Methods Group of 37 osteomas obtained from the literature review. A group of osteomas removed only by endoscopy was compared with a group in which an external approach (lateral rhynotomy or craniotomy) or combined external and endoscopic approach was applied. Results The authors, based on the statistical analysis of the literature data, have found that the average size of osteomas excised endoscopically and those removed by external approaches does not differ statistically, when the osteomas are located in the ethmoidal cells (p = 0.2691) and the frontal sinuses (p = 0.5891). Conclusion The choice of surgical method appears to be independent of the osteoma size and the decision is likely to be taken based on the experience of the surgeon, available equipment and knowledge of different surgical techniques.
Collapse
Affiliation(s)
- Maria Humeniuk-Arasiewicz
- Independent Public Research Hospital N° 7 of Silesian Medical University, Upper Silesian Medical Centre, Department of Laryngology and Laryngological Oncology, Katowice, Poland.
| | - Grażyna Stryjewska-Makuch
- Independent Public Research Hospital N° 7 of Silesian Medical University, Upper Silesian Medical Centre, Department of Laryngology and Laryngological Oncology, Katowice, Poland
| | - Małgorzata A Janik
- University of Silesia in Katowice, Institute of Computer Science, Department of Biomedical Computer Systems, Sosnowiec, Poland
| | - Bogdan Kolebacz
- Independent Public Research Hospital N° 7 of Silesian Medical University, Upper Silesian Medical Centre, Department of Laryngology and Laryngological Oncology, Katowice, Poland
| |
Collapse
|
33
|
Virk RS, Sawhney S. Osteoma of the Middle Turbinate Presenting with Frontal Lobe Abscess and Seizure. J Clin Diagn Res 2017; 11:MD01-MD03. [PMID: 28658819 DOI: 10.7860/jcdr/2017/25992.9900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 02/20/2017] [Indexed: 11/24/2022]
Abstract
Osteomas are the most common benign tumours of the sinonasal tract. Even though their location in the sinuses is well known, turbinate osteomas are quite rare. We report one such case of a 26-year-old female who presented with neurological complaints of a seizure rather than nasal complaints. The cause of the seizure was found to be a small abscess in her frontal lobe, secondary to frontal sinusitis due to a bony hard nasal mass arising from the middle turbinate. She underwent endoscopic excision of the mass which was confirmed on histopathology as an osteoma. The case highlights an unusual presentation of a middle turbinate osteoma.
Collapse
Affiliation(s)
- Ramandeep Singh Virk
- Associate Professor, Department of ENT and Head and Neck Surgery, PGIMER, Chandigarh, India
| | - Shikhar Sawhney
- Resident, Department of ENT and Head and Neck Surgery, PGIMER, Chandigarh, India
| |
Collapse
|
34
|
Anschuetz L, Buchwalder M, Dettmer M, Caversaccio MD, Wagner F. A Clinical and Radiological Approach to the Management of Benign Mesenchymal Sinonasal Tumors. ORL J Otorhinolaryngol Relat Spec 2017; 79:131-146. [PMID: 28391267 DOI: 10.1159/000468945] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 03/06/2017] [Indexed: 11/19/2022]
Abstract
PURPOSE Benign mesenchymal sinonasal neoplasms (BMSN) are rare and histologically heterogeneous. Differential diagnosis, appropriate management, and outcome are still a matter of debate. The aim of this study is to provide evidence for further refinement of assessment and treatment in the future. PROCEDURES We retrospectively reviewed data on 93 patients with neuroradiologically verified BMSN treated at our university reference center during the past 22 years. RESULTS The most frequent BMSN recorded in our cohort was osteoma of the frontal sinus. Only one-third of the patients affected were symptomatic at initial presentation. The 2 other common fibro-osseous tumor entities, fibrous dysplasia and ossifying fibroma, were confirmed in 12 and 6 patients, respectively. Patients with soft tissue tumor entities such as hemangioma, glomangiopericytoma, angiofibroma, and hamartoma were all symptomatic and underwent surgical resection. CONCLUSION Understanding and recognizing the spectrum of appearances of benign mesenchymal sinonasal tumors will improve patient assessment and clinical management. The pathognomonic neuroradiological signs of a particular tumor entity should be actively sought as the neuroradiological features may be the diagnostic clues. Computed tomography and magnetic resonance imaging play complementary roles in identifying the morphological details and locoregional staging of benign mesenchymal sinonasal tumors.
Collapse
Affiliation(s)
- Lukas Anschuetz
- University Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital Bern, University Hospital and University of Bern, Bern, Switzerland
| | | | | | | | | |
Collapse
|
35
|
Frontal skull osteoblastoma with aneurysmal bone cyst-like changes associated with trauma during pregnancy: a case report. Acta Neurochir (Wien) 2017; 159:393-396. [PMID: 27853880 DOI: 10.1007/s00701-016-3024-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 11/09/2016] [Indexed: 12/19/2022]
Abstract
We report the case of a large osteoblastoma arising in the frontal bone of a 20-year-old female. The lesion was first noted after a fall, and grew steadily in size following further head injury during pregnancy. Initial plain radiography demonstrated an area of radiolucency, with subsequent cross-sectional imaging revealing the extent of the lesion. Following successful surgical resection, histological features were suggestive of an aggressive osteoblastoma with aneurysmal bone cyst-like changes. We consider the influence of pregnancy and trauma on osteoblastoma behavior.
Collapse
|
36
|
Jeong J, Chung HJ, Yoon JH, Lee JG, Kim CH. Analysis of Histopathologic Characteristic and Treatment of Sinonasal Benign Tumor. JOURNAL OF RHINOLOGY 2017. [DOI: 10.18787/jr.2017.24.2.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Junhui Jeong
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Hyo Jin Chung
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Joo-Heon Yoon
- Department of Otorhinolaryngology, College of Medicine, Yonsei University, Seoul, Korea
| | - Jeung-Gweon Lee
- Department of Otorhinolaryngology, College of Medicine, Yonsei University, Seoul, Korea
| | - Chang-Hoon Kim
- Department of Otorhinolaryngology, College of Medicine, Yonsei University, Seoul, Korea
| |
Collapse
|
37
|
Abstract
ABSTRACT
Introduction
Fibrous dysplasia (FD) is a common benign osseous tumor that may affect the craniofacial skeletal. It is a slowly progressing disease, presenting with swelling and pressure effects on adjacent structure. Epistaxis as presenting symptom is rare. The literatures reviewed rarely mention it.
Aim
The aim of this article is to study the clinical presentation and management of extensive craniofacial FD along with review of literature, emphasizing ear, nose, and throat/endocrinal and orthopedic checkup and computer tomo graphy evaluation and related hematological workup. Serum alkaline phosphatase was also done to see its correlation to disease activity. Brief overview of management and its related complication is done.
Results
Both patients were presented with 2year history. There was no predisposing factor. Both were from tribal area. They were having slowly progressive nasal obstruction, facial swelling, and proptosis. In Case 1, it was loosening of tooth and facial pain. In Case 2, it was epistaxis which was the presenting complaint of patient. Nasal obstruction, swelling, and epistaxis in teenager male usually suggest angiofibroma. Craniofacial FD may have epistaxis and pain due to cystic degeneration in FD. Both patients had proptosis; however, their vision was normal. Serum alkaline phosphates was marginally raised, thus not signifying active disease. Computed tomography (CT) scan was diagnostic in both cases, with ground glass appear ance. In Case 2, there was cystic degeneration present and CT was useful in diagnosing the disease, to show the extent of lesion and any intracranial extension. Fine needle aspiration cytology was inconclusive and incision biopsy is better to get representative sample. Lateral rhinotomy approach with lip splitting and gingival component gave good exposure. The tumor was totally removed with thin bone at periphery. The tumor was vascular, and bleeding was controlled by anterior nasal packing.
How to cite this article
Sachdeva K. Extensive Cranio facial Fibrous Dysplasia: An Overview. Clin Rhinol An Int J 2017;10(1):1721.
Collapse
|
38
|
Benign Primary Neoplasms. CURRENT OTORHINOLARYNGOLOGY REPORTS 2016. [DOI: 10.1007/s40136-016-0138-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
39
|
Abstract
OBJECTIVE The aim of the authors was to discuss orbital complications of nasal cavity and paranasal sinus diseases. MATERIAL AND METHOD Patients with nasal and paranasal sinus diseases that affected orbit were retrospectively reviewed. Patients with primary orbital abnormality and those without radiologic orbital signs were excluded. Data regarding age and gender distribution, orbital and ocular findings, radiologic findings, and presence of an additional sinonasal disease were analyzed. RESULTS Disorders affecting orbit were categorized into 6 categories. Mean age was 41.25 ± 22.14 (range: 6-88) years and male:female ratio was 23:18. Overall, there were 41 patients including 11 patients with mucocele, 9 patients with sinusitis, 7 patients with fibrous dysplasia, 4 patients with nasal polyp, 4 patients with paranasal osteoma, and 6 patients with neoplasm. Major clinical presentation was proptosis in these patients. CONCLUSIONS Otolaryngologists should consider the possibility of sinonasal diseases to affect orbit because of vicinity of nasal cavity and paranasal sinuses to orbit. Radiologic imaging is essential to determine the extent, extension, relation with surrounding structures, and initial diagnosis of the disease, and to plan multidisciplinary management.
Collapse
|
40
|
Abstract
Pneumocephalus is an exceedingly rare complication associated with neurological deficit in cases of frontoethmoid osteoma. The overarching management strategy for affected patients remains undefined. We describe the case of a 61-year-old female patient presenting with frontoethmoid osteoma manifesting as profound intraparenchymal pneumocephalus and associated neurological deficit, treated through a minimally invasive combined surgical strategy involving image-guided burr hole decompression of the pneumocephalus followed by transnasal endoscopic removal of the tumor. Using this approach, the patient rapidly recovered full neurologic function. We review the existing literature and, given the likely intraparenchymal location of pneumocephalus associated with these lesions with the potential of rapid clinical deterioration, recommend aggressive surgical management. Although these lesions can be removed from a purely endoscopic approach, we recommend burr-hole decompression of the pneumocephalus as an adjunct to ensure prompt resolution of the neurologic symptoms.
Collapse
|
41
|
Abstract
Giant paranasal sinus osteomas are rare tumors that may be very closely adherent to surrounding anatomical structures, and complete removal of these tumors may be very challenging. We report 6 cases of giant paranasal sinus osteomas that were removed completely and discussed their symptoms, diagnostic workup, and our surgical approach. We reviewed the patient files of our 6 cases with giant paranasal osteomas and summarized their history, symptoms, diagnosis, management, and follow-up. Three of our patients underwent endoscopic sinus surgery; the other 2 patients underwent open surgical approach (osteoplastic flap procedure with bicoronal incision), and 1 patient underwent both endoscopic and open approaches, all under general anesthesia. Mean patient age was 42.6 years (range, 18-54 years). Main symptoms were headache, proptosis, and diplopia. Physical examination findings include proptosis and frontal puffiness. Paranasal sinus computed tomography revealed larger than 3-cm-diameter tumors in the frontal and ethmoid sinuses. The surgical approach to each case was customized to the location, size, and presenting symptoms of the osteoma. Histopathology revealed osteoma in all cases. All patients were evaluated with paranasal sinus computed tomography scan postoperatively. At a mean follow-up of 15 months, complication was observed in 1 patient; no residual tumor or recurrence was detected following surgery. In symptomatic cases with huge tumors, open, endoscopic, or combined approaches could be applied because of the location and size of the tumor with successful outcomes. Both endoscopic and open approaches are safe and effective methods for removal of these tumors.
Collapse
|
42
|
Sen S, Chandra A, Mukhopadhyay S, Ghosh P. Sinonasal Tumors: Computed Tomography and MR Imaging Features. Neuroimaging Clin N Am 2015; 25:595-618. [PMID: 26476382 DOI: 10.1016/j.nic.2015.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This article describes the computed tomography and MR imaging features of the neoplasms of the sinonasal space. Although a pathologic diagnosis may not always be possible, knowledge of the features may help in narrowing down the differentials and establishing a malignant pathology.
Collapse
Affiliation(s)
- Saugata Sen
- Department of Radiology and Nuclear Medicine, Tata Medical Center, 14, Main Arterial Road, Rajarhat, New Town, Kolkata 700156, India.
| | - Aditi Chandra
- Department of Radiology and Nuclear Medicine, Tata Medical Center, 14, Main Arterial Road, Rajarhat, New Town, Kolkata 700156, India
| | - Sumit Mukhopadhyay
- Department of Radiology and Nuclear Medicine, Tata Medical Center, 14, Main Arterial Road, Rajarhat, New Town, Kolkata 700156, India
| | - Priya Ghosh
- Department of Radiology and Nuclear Medicine, Tata Medical Center, 14, Main Arterial Road, Rajarhat, New Town, Kolkata 700156, India
| |
Collapse
|
43
|
Giant Nasal Septal Osteoma Arising From Perpendicular Lamina of the Ethmoid Bone. J Craniofac Surg 2015; 26:953-4. [DOI: 10.1097/scs.0000000000001424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
44
|
McCann JM, Tyler D, Foss RD. Sino-Orbital Osteoma With Osteoblastoma-Like Features. Head Neck Pathol 2015; 9:503-6. [PMID: 25663319 PMCID: PMC4651934 DOI: 10.1007/s12105-015-0613-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 01/30/2015] [Indexed: 10/24/2022]
Abstract
An 18 year old male presented with worsening headaches, pain with ocular movement and swelling that involved the left anterior periorbital and frontal sinus region. Radiographic images revealed a polypoid bony mass of mixed radiodensity extending into the left and right frontal sinuses. Histologic examination of the resection material resulted in the diagnosis of an osteoma with osteoblastoma-like features, an osteoma variant that has zones indistinguishable from an osteoblastoma. The clinical, radiographic, and morphologic features of sino-orbital osteoma with osteoblastoma-like features are discussed.
Collapse
Affiliation(s)
- James M. McCann
- Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96859 USA
| | - Donald Tyler
- San Antonio Military Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, San Antonio, TX 78234 USA
| | - Robert D. Foss
- Dermatopathology and Oral Pathology Division, Johns Hopkins Dermatopathology Laboratory, 600 N. Wolfe Street, Blalock 907, Baltimore, MD 21287 USA
| |
Collapse
|
45
|
Khattab DM, Mohamed SEDD, Barakat MS, Shama SA. Role of multidetector computed tomography in assessment of fibro-osseous lesions of the craniofacial complex. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2014. [DOI: 10.1016/j.ejrnm.2014.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
46
|
Hershkovitz I, Spigelman M, Sarig R, Lim DS, Lee IS, Oh CS, May H, Boaretto E, Kim YS, Lee SD, Peled N, Kim MJ, Toledano T, Bar-Gal GK, Shin DH. A possible case of cherubism in a 17th-century Korean mummy. PLoS One 2014; 9:e102441. [PMID: 25093864 PMCID: PMC4122385 DOI: 10.1371/journal.pone.0102441] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 05/26/2014] [Indexed: 11/18/2022] Open
Abstract
Cherubism is a benign fibro-osseous disease of childhood limited specifically to the maxilla and mandible. The progressive replacement of the jaw bones with expansile multilocular cystic lesions causes eventual prominence of the lower face, and hence the classic “cherubic” phenotype reflecting variable extents of jaw hypertrophy. Histologically, this condition has been characterized as replacement of the normal bone matrix with multicystic pockets of fibrous stroma and osteoclastic giant cells. Because of radiographic features common to both, primarily the presence of multiloculated lucencies with heterogeneous “ground-glass” sclerosis on CT imaging, cherubism was long mistaken for a craniofacial subtype of fibrous dysplasia. In 1999, however, the distinct genetic basis for cherubism was mapped to chromosome 4p16.3 and the SH-3 binding protein SH3BP2. But while there are already three suspected cases of fibrous dysplasia amongst archaeological populations, no definitive cases of cherubism have yet been reported in historical populations. In the current study we describe micro- and macro-structural changes in the face of a 17th century Joseon Dynasty Korean mummy which may coincide with the clinic-pathologic and radiologic features of cherubism.
Collapse
Affiliation(s)
- Israel Hershkovitz
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- * E-mail: (IH); (DHS)
| | - Mark Spigelman
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Rachel Sarig
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Do-Sun Lim
- Department of Dental Hygiene, Eulji University, Seongnam, Gyeonggi-do, Korea
| | - In Sun Lee
- Department of Diagnostic Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Chang Seok Oh
- Department of Anatomy, Seoul National University College of Medicine, Seoul, Korea
- Institute of Forensic Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hila May
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Elisabetta Boaretto
- D-REAMS Radiocarbon Dating Laboratory, Weizmann Institute of Science, Rehovot, Israel
| | - Yi-Suk Kim
- Department of Anatomy, Ewha Womans University School of Medicine, Seoul, Korea
| | - Soong Deok Lee
- Institute of Forensic Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Forensic Science, Seoul National University College of Medicine, Seoul, Korea
| | - Nathan Peled
- Department of Radiology, Carmel Medical Center, Haifa, Israel
| | - Myeung Ju Kim
- Department of Anatomy, Dankook University College of Medicine, Yongin-si, Gyeonggi-do, Korea
| | - Talya Toledano
- Department of Radiology, Maimonides Medical Center, Brooklyn, New York, United States of America
| | - Gila Kahila Bar-Gal
- Department of Virology, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Dong Hoon Shin
- Department of Anatomy, Seoul National University College of Medicine, Seoul, Korea
- Institute of Forensic Medicine, Seoul National University College of Medicine, Seoul, Korea
- * E-mail: (IH); (DHS)
| |
Collapse
|
47
|
Collin M, Roman S, Fernandez C, Triglia JM, Nicollas R. Ossifying fibroma of the middle turbinate revealed by infection in a young child. Eur Ann Otorhinolaryngol Head Neck Dis 2013; 131:193-5. [PMID: 24139075 DOI: 10.1016/j.anorl.2013.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 04/17/2013] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Ossifying fibroma (OF) is a rare benign fibro-osseous tumor, mainly located in the head and neck region. Most often, it affects the mandible but rare involvement of paranasal sinuses has been reported, associated with more locally aggressive behavior. CASE REPORT We report the case of an 8-year-old boy with OF of the middle turbinate, revealed by ethmoiditis. Total resection was performed on an endoscopic approach. The patient was free of clinical or radiological recurrence at 3 years' follow-up. This was the youngest patient with OF of the middle turbinate so far reported in the international literature. DISCUSSION Presumptive diagnosis is established by clinical examination and CT scan (location, oval-shaped mass, heterogeneous tumor with a thin bony rim). Definitive diagnosis is founded on histological examination (psammomatous bodies, osteoblastic rim, trabecular bone). Treatment in paranasal sinus OF is surgical, preferentially on an endoscopic approach. Resection should be as complete as possible to minimize risk of recurrence, especially in sinonasal locations, known to be more aggressive. Ethmoiditis in an unusual age-range should suggest tumoral etiology.
Collapse
Affiliation(s)
- M Collin
- Service d'ORL et chirurgie cervico-faciale pédiatrique, pôle de pédiatrie médico-chirurgicale, hôpital d'enfants de La Timone, Aix-Marseille université, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - S Roman
- Service d'ORL et chirurgie cervico-faciale pédiatrique, pôle de pédiatrie médico-chirurgicale, hôpital d'enfants de La Timone, Aix-Marseille université, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - C Fernandez
- Service d'anatomopathologie, hôpitaux de La Timone, Aix-Marseille université, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - J-M Triglia
- Service d'ORL et chirurgie cervico-faciale pédiatrique, pôle de pédiatrie médico-chirurgicale, hôpital d'enfants de La Timone, Aix-Marseille université, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - R Nicollas
- Service d'ORL et chirurgie cervico-faciale pédiatrique, pôle de pédiatrie médico-chirurgicale, hôpital d'enfants de La Timone, Aix-Marseille université, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
| |
Collapse
|
48
|
Affiliation(s)
- S.B. Mali
- Oral and Maxillofacial Surgery; CSMSS Dental College Aurangabad; Aurangabad India
| |
Collapse
|
49
|
Alotaibi N, Hanss J, Benoudiba F, Bobin S, Racy E. Endoscopic removal of large orbito-ethmoidal osteoma in pediatric patient: Case report. Int J Surg Case Rep 2013; 4:1067-70. [PMID: 24212759 PMCID: PMC3860021 DOI: 10.1016/j.ijscr.2013.07.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Revised: 06/25/2013] [Accepted: 07/10/2013] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Osteoma is a benign slow growing bone tumor with a prevalence of 3% of all benign paranasal sinuses tumors, with a peak incidence between the fourth and sixth decades, mostly involving frontal sinuses.1 PRESENTATION OF CASE We present a case of a large right ethmoidal sinus osteoma in a 12-year-old boy, complaining of frontal headaches and excessive lacrimation of the right eye. CT scan showed a very large tumor in the right anterior ethmoidal sinus (30 mm × 25 mm × 15 mm). DISCUSSION Large osteomas of the paranasal sinuses are usually resected by external approaches. However, the minimally invasive endonasal approach, which minimizes external facial scarring, is challenging for such large lesions in pediatrics. In the presented case, the osteoma was successfully resected exclusively by endoscopy-guided endonasal approach assisted by neuronavigation, with no peri or postoperative complications. CONCLUSION An endoscopic approach assisted with neuronavigation may be a minimally invasive and safe procedure for managing large osteoma of the ethmoidal sinus in pediatrics patients.
Collapse
Affiliation(s)
- Naif Alotaibi
- Otorhinolaryngology Department, Kremlin-Bicêtre Hospital, Assistance Publique Hopitaux de Paris (AP-HP), Le Kremlin Bicêtre, France.
| | | | | | | | | |
Collapse
|
50
|
Erdim I, Yazici ZM, Yilmazer R, Sever N, Kayhan FT. A huge cemento-ossifying fibroma of paranasal sinus: a case report. ACTA MEDICA (HRADEC KRÁLOVÉ) 2013; 55:146-9. [PMID: 23297525 DOI: 10.14712/18059694.2015.54] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Cemento-ossifying fibroma is a well-bordered, slow-growing, benign fibro-osseous disease. Although its localization is generally in the mandible, it can be seen in any area of the craniofacial region. Radiology and histopathology help to diagnose the condition. Treatment is based on close observation and/or surgical excision. In this case, we report the case of a 62-year-old male patient who had a large radiological appearance, cemento-ossifying fibroma in the paranasal sinuses.
Collapse
Affiliation(s)
- Ibrahim Erdim
- Department of Otorhinolaryngology, Bakirköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
| | | | | | | | | |
Collapse
|