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Azab MA. Ossifying fibroma of the ethmoid and sphenoid sinuses: A report of a rare case and literature review. Surg Neurol Int 2024; 15:38. [PMID: 38468684 PMCID: PMC10927173 DOI: 10.25259/sni_182_2023] [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: 02/23/2023] [Accepted: 01/10/2024] [Indexed: 03/13/2024] Open
Abstract
Background Fibro-osseous lesions include a variety of bone lesions with different clinical and histopathological features. Case Description We report a case of cemento-ossifying lesion involving the left ethmoid and sphenoid sinus in a 17-year-old male patient. Computed tomography showed an expansile hyperdense lesion with sclerosed peripheral mantle epicentered on the left ethmoid and sphenoid sinus and extending into the left nasal cavity. Magnetic resonance imaging was done for preoperative planning. Transnasal endoscopic resection was performed and histopathological examination confirmed the diagnosis of ossifying fibroma (OF). Conclusion Involvement of the ethmoid sinus with OF is a rare condition; therefore, we examined the literature for similar cases to highlight the possible clinical presentation and management. Endoscopic management is a safe, effective approach with a low rate of complications.
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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.
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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
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3
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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.
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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
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4
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Idani M, Millogo M, Badini SAP, Ili BV, Zango A, Nongkouni G, Konsem T. Ossifying fibroma of the jawbones: Epidemiology and management in the Yalgado ouedrago university hospital. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2021.100248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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5
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Endoscopic Resection of a Massive Ossifying Fibroma in the Sinonasal Cavity. J Craniofac Surg 2021; 32:1800-1802. [PMID: 33534305 DOI: 10.1097/scs.0000000000007504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT An ossifying fibroma (OF) is a type of benign fibro-osteoma that rarely involves the sinonasal cavity. Recent developments in endoscopic sinus surgery allow the removal of large benign tumors from the nasal cavity and sinuses. Here, the athors report the case of a 48-year-old female who underwent endoscopic sinus surgery under general anesthesia to completely remove a large OF involving the sphenoid sinus and nasal cavity. No recurrence was noted during the recent 3-year follow-up. Endoscopic resection of OFs is an excellent choice for very experienced surgeons, affording the advantages of direct observation as well as visual enhancement and magnification, thus reducing intra- and post-operative morbidity.
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Lyoubi M, Beghdad M, Hammouda Y, Oukessou Y, Rouadi S, Mahtar M. Entirely endoscopic resection of a complicated juvenile psammomatoid ossifying fibroma of the paranasal sinusitis: Case report and review of the literature. Int J Surg Case Rep 2021; 81:105754. [PMID: 33743250 PMCID: PMC8010469 DOI: 10.1016/j.ijscr.2021.105754] [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: 02/05/2021] [Revised: 03/05/2021] [Accepted: 03/05/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction Juvenile ossifying fibroma (OF) is a benign fibro-osseous tumor, affecting the bones of the face. It’s locally very aggressive, with a strong tendency to recur. We report a case of a juvenile psammomatoid ossifying fibroma (JPOF) complicated with exophthalmos undergoing an entirely endoscopic resection. Clinical presentation A 14-years-old, young woman presented with a 7 months history of headache and right chronic tearing complicated with exophthalmos. Nasal endoscopy revealed a polylobed mass filling the right nasal cavity, the ophthalmic examination showed an isolated exophthalmos. CT scan revealed a well-limited benign mass covered by a thick shell of bone, pushing out the orbital lamina papyracea responsible for a grade 1 exophthalmos. On the facial MRI, we excluded intracranial or intraorbital involvement. A biopsy of the mass describes a psammomatoid juvenile ossifying fibroma. The patient underwent endoscopic transnasal approach with image-guided neuro-navigation system. Clinical discussion JPOF is an aggressive variant of ossifying fibroma occurring predominantly in children with a predilection for the paranasal sinuses. CT scan images show a characteristic well-limited benign expansile mass covered by a thick shell of bone, but sometimes it’s mistaken for a mucocele. MRI helps with excluding intracranial or intraorbital involvement. Endonasal endoscopic approaches have been increasingly used and it tends to become the new standard of care. Conclusion Treatment consists of complete surgical removal; incomplete resection is associated with a high local recurrence rate. Clinician should keep in mind the need for clinical and radiological follow-up for many years.
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Affiliation(s)
- Mouna Lyoubi
- ENT Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II University, 20000, Casablanca, Morocco.
| | - Mohamed Beghdad
- ENT Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II University, 20000, Casablanca, Morocco.
| | - Yassir Hammouda
- ENT Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II University, 20000, Casablanca, Morocco.
| | - Youssef Oukessou
- ENT Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II University, 20000, Casablanca, Morocco.
| | - Sami Rouadi
- ENT Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II University, 20000, Casablanca, Morocco.
| | - Mohamed Mahtar
- ENT Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II University, 20000, Casablanca, Morocco.
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7
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Endoscopic endonasal removal of a pediatric paranasal ossifying fibroma using preoperative embolization. OTOLARYNGOLOGY CASE REPORTS 2020. [DOI: 10.1016/j.xocr.2019.100147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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8
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Gutierrez LB, Link TM, Horvai AE, Joseph GB, O'Donnell RJ, Motamedi D. Secondary aneurysmal bone cysts and associated primary lesions: imaging features of 49 cases. Clin Imaging 2020; 62:23-32. [PMID: 32036238 DOI: 10.1016/j.clinimag.2020.01.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/13/2020] [Accepted: 01/27/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To describe the imaging, anatomic, and clinical features of a series of secondary aneurysmal bone cysts (ABC) and to ascertain their most commonly associated primary bone lesions. METHODS Forty-nine cases of histopathologically proven secondary ABCs were retrospectively reviewed. Demographic data and clinical history were obtained. Radiographic, computed tomographic, magnetic resonance, and nuclear medicine imaging were analyzed. Lesion location, imaging characteristics, and associated primary lesions were documented. Linear regression analysis and Chi-squared testing was performed for statistical analysis. RESULTS Twenty-four males and 25 females were included, with an age range of 8-79 years (mean 29.7 + - 4.5 years). Eleven types of primary bone lesion were identified, with giant-cell tumor (n = 17, 35%), chondroblastoma (n = 11, 22%), fibrous dysplasia (n = 6, 12%), osteoblastoma (n = 4, 8%) and osteosarcoma (n = 4, 8%) being the most frequent. The lesions involved chiefly the long bone epiphyses (n = 25, 51%). Secondary ABC imaging findings and locations most closely approximated those of their primary counterparts, although fluid-fluid levels were seen at a higher frequency than previously reported in primary chondroblastoma (9/11, 82%), fibrous dysplasia (2/6, 33%), osteoblastoma (4/4, 100%), osteosarcoma (3/4, 75%), and chondromyxoid fibroma (1/2, 50%). CONCLUSION The most common primary lesions associated with secondary ABC were giant cell tumor and chondroblastoma, located in the long bone epiphyses. The majority of the secondary ABCs demonstrate predominant imaging characteristics typical of the primary bone lesions, but with a higher presence of fluid-fluid levels.
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Affiliation(s)
- Luis B Gutierrez
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, San Francisco, CA 94143, United States of America.
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, San Francisco, CA 94143, United States of America
| | - Andrew E Horvai
- Department of Pathology, University of California, San Francisco, 505 Parnassus Ave, San Francisco, CA 94143, United States of America
| | - Gabby B Joseph
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, San Francisco, CA 94143, United States of America
| | - Richard J O'Donnell
- Department of Orthopaedic Surgery, University of California, San Francisco, 505 Parnassus Ave, San Francisco, CA 94143, United States of America
| | - Daria Motamedi
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, San Francisco, CA 94143, United States of America
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Alghonaim Y, ALRashed ALHumaid S, Arafat A. Aggressive ossifying fibroma of right ethmoidal sinus: A case report. Int J Surg Case Rep 2017; 53:513-516. [PMID: 29373206 PMCID: PMC6290393 DOI: 10.1016/j.ijscr.2017.12.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 12/20/2017] [Accepted: 12/21/2017] [Indexed: 11/29/2022] Open
Abstract
Ossifying fibroma is a rare benign fibro-osseous lesion seen in the bones of the head and neck area. It is mostly found in the mandible followed by the maxilla and rarely in the paranasal sinuses along with the orbit and skull bones. It is crucial to be aware of the features of ossifying fibroma in this uncommon site for better outcomes of the different craniofacial tumors.
Background Ossifying fibroma is a rare benign fibro-osseous lesion seen in the bones of the head and neck area. It is mostly found in the mandible followed by the maxilla and rarely in the paranasal sinuses along with the orbit and skull bones. Case presentation A 30-year-old male patient presented with headache and incidental finding of a right ethmoidal sinus ossifying fibroma by paranasal-sinuses CT scan and MRI of the face. A flexible fiber-optic nasal endoscopy examination revealed a right side fullness. A non-contrasted CT scan of the paranasal sinus showed hyperdense lesion at the right ethmoid air cells. Functional endoscopic sinus surgery was performed and multiple nasal-mass biopsies were taken which showed fibro-osseous lesion most consistent with aggressive ossifying fibroma. Later, a near total resection of skull base tumor by endoscopic surgery was done and patient was discharged next day in a good condition. Conclusion Ossifying fibroma is a rare lesion found in the head and neck area and it is unusual to be found in the paranasal sinuses. Thus crucial attention to the clinical, radiographical and histopathological examination should be taken for more accurate diagnosis and thus appropriate management.
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Affiliation(s)
- Yazeed Alghonaim
- King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences, ENT Division, Department of Surgery, King Abdulaziz Medical City, NGHA, Saudi Arabia
| | - Salwa ALRashed ALHumaid
- King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences, ENT Division, Department of Surgery, King Abdulaziz Medical City, NGHA, Saudi Arabia.
| | - Abdullah Arafat
- King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences, ENT Division, Department of Surgery, King Abdulaziz Medical City, NGHA, Saudi Arabia
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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.
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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
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11
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Wang M, Zhou B, Cui S, Li Y. Juvenile psammomatoid ossifying fibroma in paranasal sinus and skull base. Acta Otolaryngol 2017; 137:743-749. [PMID: 28125310 DOI: 10.1080/00016489.2016.1276302] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
CONCLUSION The endoscopic transnasal approach with IGS is a safe and effective technique, allowing completely resection of JPOF, with minimal morbidity and recurrence. OBJECTIVES JPOF is a benign but locally aggressive fibro-osseous lesion. This study presents a series of JPOF cases, involving anterior skull base and orbit, treated by endoscopic transnasal approach with image guidance system (IGS) to resect the mass completely. METHOD This study retrospectively reviewed the clinical presentations, surgical procedures, and complications of 11 patients with JPOF who were treated by endoscopic approach from May 2009 to April 2014. All patients were followed by endoscopic and CT scan evaluations during follow-up. RESULTS All of the 11 cases were boys, with a mean age of 11.8 years (range = 6-17 years). The size of mass in the paranasal sinus ranged from 2.5-4.6 cm in greatest dimension (mean = 3.7 cm), and the medial orbital wall and cranial base were involved in all patients. All 11 patients received successful operation and were relieved from symptoms without mortality and major complications. During follow-up (range from 17-67 months; mean follow-up = 25.8 months), only one patient was recurrent in local position. The skull base partial resected during surgery was found to rebuild after 1 year.
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Affiliation(s)
- Mingjie Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital Capital Medical University, Beijing, PR China
| | - Bing Zhou
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital Capital Medical University, Beijing, PR China
| | - Shunjiu Cui
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital Capital Medical University, Beijing, PR China
| | - Yunchuan Li
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital Capital Medical University, Beijing, PR China
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12
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Leask R, Steyl J. Mycotic rhinitis in a Mutton Merino ewe. J S Afr Vet Assoc 2017. [DOI: 10.4102/jsava.v88.1429] [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
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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]
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14
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Jurlina M, Skitarelić N, Passali D, Passali F, Mladina R. Endonasal endoscopic resection of ossifying fibroma involving the ethmoid sinus, orbit and anterior skull base: case report and literature review. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2016; 36:144-8. [PMID: 27196080 PMCID: PMC4907162 DOI: 10.14639/0392-100x-674] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 06/01/2015] [Indexed: 11/23/2022]
Abstract
Ossifying fibroma is a benign fibro-osseous tumour that rarely involves the ethmoid sinuses and orbit. It is classified as a benign fibroosseous lesion, a term that is synonymous with a variety of lesions reported in the literature. Recurrence rate with deleterious effects in cases of extramandibular ossifying fibroma is the impetus for open en bloc resection of the tumour. Continuously evolving techniques in endonasal endoscopic sinus surgery has rendered resection of large benign sinonasal and cephalonasal tumours possible. The authors report a case of ossifying fibroma involving the ethmoid sinus, orbit and anterior skull base in a 65-year-old previously healthy woman completely resected by endonasal endoscopic sinus surgery. The patient was free from postoperative complications and was dismissed from hospital on the sixth postoperative day. At present, the patient is disease-free at a regular five-year postoperative follow-up. Endonasal endoscopic resection of sinonasal ossifying fibromas is an excellent therapeutic option when performed by a surgeon experienced in endoscopic sinonasal surgery. The advantages of an endonasal endoscopic approach include direct visualization, enhanced visibility and magnification resulting in decreased intraoperative and postoperative morbidity. Aesthetic outcome is excellent in the absence of facial scars.
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Affiliation(s)
- M. Jurlina
- Department of Otolaryngology Head and Neck Surgery, University Hospital Rebro, Zagreb, Croatia
| | - N. Skitarelić
- Department of Otolaryngology Head and Neck Surgery, General Hospital Zadar, Zadar, Croatia
| | - D. Passali
- Department of ORL, University of Siena, Italy
| | - F.M. Passali
- Department of ORL University of Rome Tor Vergata, Italy
| | - R. Mladina
- Department of Otolaryngology Head and Neck Surgery, University Hospital Rebro, Zagreb, Croatia
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15
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Arrested Pneumatization of the Sphenoid Sinus on Large Field-of-View Cone Beam Computed Tomography Studies. Dent J (Basel) 2015; 3:67-76. [PMID: 29567926 PMCID: PMC5851199 DOI: 10.3390/dj3020067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 05/05/2015] [Accepted: 05/07/2015] [Indexed: 11/22/2022] Open
Abstract
Arrested pneumatization of the sphenoid sinus is a normal anatomical variant. The aim of this report is to define cone beam computed tomography (CBCT) characteristics of arrested pneumatization of sphenoid sinus in an effort to help differentiate it from invasive or lytic skull base lesions. Two cases are presented with incidental findings. Both studies, acquired for other diagnostic purposes, demonstrated unique osseous patterns that were eventually deemed to be anatomic variations in the absence of clinical signs and symptoms although the pattern of bone loss and remodeling was diagnosed as pneumatization of the sphenoid sinus by a panel of medical and maxillofacial radiologists following contrasted advanced imaging. It is important to differentiate arrested pneumatization of the sphenoid sinus from lesions, such as arachnoid granulations, acoustic neuroma, glioma, metastatic lesions, meningioma, or chordoma, to prevent unnecessary biopsies or exploratory surgeries that would consequently reduce treatment costs and alleviate anxiety in patients.
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16
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Endoscopic resection of sinonasal ossifying fibroma: 31 cases report at an institution. Eur Arch Otorhinolaryngol 2014; 271:2975-82. [PMID: 24652115 DOI: 10.1007/s00405-014-2972-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 02/20/2014] [Indexed: 10/25/2022]
Abstract
A retrospective analysis of 31 lesions undergoing endoscopic surgery between 2006 and 2012 was undertaken. The data of patients' demographics, clinical features, operative parameters, follow-up period, and treatment outcomes were collected. A total of 31 patients were reviewed and consisted of 19 females and 12 males. The median age was 23 years (range 6-55). The surgical strategy included the exclusive endoscopic approach in 26 cases, endoscopic approach with external approach in 5 cases. Twenty-two cases were achieved completely resection and nine cases were subtotally resected. During the follow-up period (median: 25 months, range 4-80 months), 4 cases developed recurrences and there was no evidence of recurrence in the additional 27 cases included 8 cases living with no progressively growing residual tumor and 19 cases living without diseases. Our experience indicates that the endoscopic approach to manage ossifying fibroma of the nose and paranasal sinuses is safe and effective. However, more cases and a longer period of follow-up are required to define its long-term therapeutic effect.
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17
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Benign fibro-osseous lesions of the jaws in children. A 12-year retrospective study. J Craniomaxillofac Surg 2013; 41:574-80. [DOI: 10.1016/j.jcms.2012.11.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2012] [Revised: 11/26/2012] [Accepted: 11/27/2012] [Indexed: 12/16/2022] Open
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Manes RP, Ryan MW, Batra PS, Mendelsohn D, Fang YV, Marple BF. Ossifying fibroma of the nose and paranasal sinuses. Int Forum Allergy Rhinol 2012; 3:161-8. [PMID: 22736440 DOI: 10.1002/alr.21067] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Revised: 05/22/2012] [Accepted: 05/27/2012] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this work was to perform a systematic review regarding ossifying fibroma and its multiple variants of the paranasal sinuses, and to identify any clinical differences between the multiple variants. METHODS A search of the U.S. National Library of Medicine (PubMed) database was performed for the non–Medical Subject Heading (MeSH) search term “ossifying fibroma.” The bibliographies of the retrieved manuscripts were searched to identify additional potentially relevant articles. Finally, textbooks of head and neck pathology were searched to identify peer-reviewed literature that addresses the histopathology of ossifying fibroma and its variants. Abstracts were screened by 2 of the authors to identify reports of ossifying fibroma lesions (and its variants) that involved the paranasal sinuses. Extracted data from case reports or case series included the clinical presentation, age, gender, site of involvement, surgical approach, treatment outcome, follow-up period, and recurrence rate. Information derived from cases is summarized in tables, and simple descriptive statistics were applied to the data. RESULTS A total of 137 distinct patients were identified in 103 reports. Extracted data did not show any appreciable difference in clinical presentation or outcomes. Data on recurrence of these lesions was often limited by a lack of follow-up. CONCLUSION Although differentiation between the subtypes of ossifying fibroma can be made histologically, and a diverse nomenclature exists, there does not appear to be any overriding clinical significance to the histopathologic differentiation of OF variants.
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Affiliation(s)
- R Peter Manes
- Section of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, CT 06520, USA.
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19
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Juvenile psammomatoid ossifying fibroma: a review. Oral Oncol 2011; 47:1110-6. [PMID: 21840246 DOI: 10.1016/j.oraloncology.2011.06.513] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Revised: 06/26/2011] [Accepted: 06/28/2011] [Indexed: 11/23/2022]
Abstract
In WHO classification of odontogenic tumors (2005), juvenile ossifying fibroma (JOF) is divided into juvenile psammomatoid ossifying fibroma (JPOF) and juvenile trabecular ossifying fibroma (JTOF). JPOF has been distinguished because of its location, clinical behavior, and age of occurrence. It is generally seen in younger age group and the most common site is paranasal sinuses, orbits, and fronto-ethmoidal complex. Radiologically, the internal structure can be radiolucent, mixed, or radiopaque, depending on the degree of calcification and extent of the cystic changes. Histologically, it is characterized by a densely cellular fibrous stroma interspersed with numerous psammoma bodies. The treatment is "en bloc" surgical excision while in case of intracranial extension, tumor removal may need a combination of neurosurgical and transfacial approach. Malignant transformation and metastasis has not been reported but recurrence is common. The purpose of this narrative review article is to discuss the various aspects of JPOF reported in the English medical literature.
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20
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Paranasal ossifying fibroma: endoscopic resection or wait and scan? Eur Arch Otorhinolaryngol 2011; 268:999-1004. [DOI: 10.1007/s00405-011-1503-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2010] [Accepted: 01/20/2011] [Indexed: 10/18/2022]
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21
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Wong WK, Matsuwaki Y, Omura K, Moriyama H. Role of intraoperative CT-updates during image-guided endoscopic sinus surgery for sinonasal fibro-osseous lesions. Auris Nasus Larynx 2011; 38:628-31. [PMID: 21227612 DOI: 10.1016/j.anl.2010.11.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 11/14/2010] [Accepted: 11/17/2010] [Indexed: 11/18/2022]
Abstract
Fibrous dysplasia, ossifying fibroma and osteomas are collectively known as fibro-osseous lesions. Occurrence in the sinonasal region is rare, and its management can be technically challenging. We report a case of an 8-year-old female with cemento-ossifying fibroma of the ethmoid sinus who underwent a two-staged, endoscopically assisted, transfacial resection of the lesion and a 31-year-old male with fibrous dysplasia of the ethmoid sinus who underwent endoscopic removal of the tumor. Both cases utilized intraoperative computed tomography (CT)-updated image-guided systems (IGS) to improve surgical precision. In the second patient, further resection was undertaken after CT-update in the same surgery. The postoperative courses were uneventful, and at 1-year follow-up no tumor recurrence was observed in either patient. Our experience suggested that the use of intraoperative CT-updated IGS in endoscopic or endoscopically assisted surgeries for sinonasal fibro-osseous lesions will lead to more optimal tumor control, which can translate into greater patient safety.
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Affiliation(s)
- Wai Keat Wong
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
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22
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Transcranial resection of a large sinonasal juvenile psammomatoid ossifying fibroma. Childs Nerv Syst 2009; 25:1115-20. [PMID: 19308423 DOI: 10.1007/s00381-009-0867-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2008] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Juvenile psammomatoid ossifying fibroma (JPOF) is a benign but potentially locally aggressive fibroosseous lesion predominantly arising in the paranasal sinuses in children and young adults. Intracranial extension is rare but occurs sometimes. In such cases, tumor resection may often require the combination of neurosurgical and facial approaches. Histological diagnosis remains a challenge because the lesion can be easily mistaken for another fibroosseous lesion or for a meningioma. CASE REPORT We report the case of a 12-year-old boy with a JPOF arising from the right paranasal sinuses and extension towards the anterior skull base and the orbit. Despite the tumor had eroded through nasal septum, medial orbit wall, and right maxilla, it could be entirely removed performing an extended frontobasal approach via a bifrontoorbital craniotomy, obviating the need for a transfacial approach. CONCLUSION Radiologically and histologically, the lesion could be mistaken either for a meningioma or another type of ossifying fibroma. Histological aspects and alternative surgical approaches to these rare entities are discussed.
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23
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Khademi B, Niknejad N, Mahmoudi J. An Aggressive Psammomatoid Ossifying Fibroma of the Sinonasal Tract: Report of a Case. EAR, NOSE & THROAT JOURNAL 2007. [DOI: 10.1177/014556130708600716] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aggressive psammomatoid ossifying fibromas (APOFs) represent a subgroup of related fibro-osseous lesions that appears to be unique to the nasal cavity, paranasal sinuses, and orbit. These rare lesions are characterized by distinctive histomorphologic features and a tendency to affect younger patients. Histologically they are benign, but clinically they are locally aggressive. We report the case of a 15-year-old boy who had a large APOF in the left ethmoid and sphenoid sinuses. The location of this tumor made this case unusual.
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Affiliation(s)
- Bijan Khademi
- Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nika Niknejad
- Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jalal Mahmoudi
- Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
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24
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Galvan O, Gassner EM, Neher A, Gunkel AR. Fibro-osseous lesion of the middle turbinate: ossifying fibroma or fibrous dysplasia? The Journal of Laryngology & Otology 2007; 121:1201-3. [PMID: 17349097 DOI: 10.1017/s0022215107006524] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Benign fibro-osseous tumours of the head and neck region seldom appear in the midface and nasal cavity. Correct differential diagnosis of fibro-osseous tumours is crucial for adequate therapy, as their clinical aggressiveness seems to differ. The rather uncommon case of a 14-year-old boy with a tumour of the middle turbinate is presented. The radiologic appearance of the tumour, on computed tomography and magnetic resonance imaging scans, was consistent with fibrous dysplasia. Angiography revealed extensive vascularisation of the tumour from both the internal and external carotid arteries. To avoid ipsilateral blindness following embolisation, a superselective embolisation of the supplying blood vessels was performed. The tumour was completely resected via an endoscopic approach. Histopathology revealed an ossifying fibroma. This case emphasises the importance of interpretation of the clinical, radiological and histological features before planning definitive treatment. Moreover, when fibro-osseous tumours are suspected, the possibility of extensive, complicated vascularisation must be considered. This case underwent radical resection, with no recurrence after four years' follow up.
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Affiliation(s)
- O Galvan
- Department of Otorhinolaryngology, Innsbruck University Hospital, Austria.
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25
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Firat Y, Firat AK, Karakaş HM, Onal C. A case of frontal lobe abscess as a complication of frontal sinus ossifying fibroma. Dentomaxillofac Radiol 2007; 35:447-50. [PMID: 17082337 DOI: 10.1259/dmfr/28037887] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Sinonasal ossifying fibroma is a rare, slow-growing, benign bony tumour, frequently involving the maxilla and mandible in the head and neck region. Although it is known to be the second most frequent fibro-osseous tumour of paranasal sinus, to the best of our knowledge, ossifying fibroma of frontal sinus causing brain abscess has not been presented yet in the relevant literature. We present the clinical, pathological and radiological findings of ossifying fibroma of the frontal sinus associated with brain abscess.
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Affiliation(s)
- Y Firat
- Department of Otorhinolaryngology, Inonu University School of Medicine, Malatya, Turkey.
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26
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Mehta D, Clifton N, McClelland L, Jones NS. Paediatric fibro-osseous lesions of the nose and paranasal sinuses. Int J Pediatr Otorhinolaryngol 2006; 70:193-9. [PMID: 16321450 DOI: 10.1016/j.ijporl.2005.09.031] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2005] [Revised: 09/26/2005] [Accepted: 09/30/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The term "fibro-osseous lesion" is a generic description for a group of lesions involving the paranasal sinuses and anterior skull base. We aim to improve understanding of the clinical and pathological presentation of fibro-osseous lesions in children. METHODS AND RESULTS We report two cases of aggressive "fibro-osseous" lesions arising from paranasal sinuses and anterior skull base in childhood that were successfully managed surgically. We compare our case reports with a review of the available literature and evaluate the management of these lesions. CONCLUSIONS The clinical behaviour and radiological features of fibro-osseous lesions is variable. Aggressive lesions require a radical surgical approach to ensure complete excision, in spite of an increase in associated morbidity. Incomplete excision of aggressive lesions may result in disease recurrence with severe morbidity or mortality. In contrast a slowly progressive lesion often does not warrant extensive surgical excision. Understanding the nature of fibro-osseous lesions facilitates appropriate clinical management.
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Affiliation(s)
- D Mehta
- Department of Otorhinolaryngology and Head and Neck Surgery, Queens Medical Centre, Nottingham, UK
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27
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Abstract
Fibroosseous lesions of the maxilla and paranasal sinuses differ from one another in their prognosis and treatment, with the most important distinction being that of an ossifying fibroma (OF) and fibrous dysplasia. A clinically significant OF with its potentially more aggressive behavior must be completely resected. A look at historical and current approaches along with a case report of a 19-year-old woman with a recurrent sinonasal OF removed using endoscopic techniques are discussed. The case adds to the growing amount of literature showing a successful alternative to open surgery for large benign sinonasal tumors, when the character of the tumor, desire of the patient, and expertise of the physician permit endoscopic resection. With the improving techniques of sinonasal endoscopy, better care can be provided with less invasive surgery resulting in less recovery time, more aesthetically pleasing results, and decreased potential for infection.
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Affiliation(s)
- Garrett Post
- Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia, Augusta, GA 30912-4060, USA
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Caylakli F, Buyuklu F, Cakmak O, Ozdemir H, Ozluoglu L. Ossifying fibroma of the middle turbinate: a case report. Am J Otolaryngol 2004; 25:377-8. [PMID: 15334407 DOI: 10.1016/j.amjoto.2004.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Ossifying fibromas (OFs) are rare, benign, nonaggressive fibroosseous tumors that are commonly seen in head and neck region. They show aggressive pattern when the midface and paranasal sinuses are involved. We report a 28-year-old woman with OF of the middle turbinate. Computed tomography images of the nasal cavity showed monostotic hyperdense lesion confined to middle turbinate. En bloc excision was performed. Histological examination confirmed the diagnosis as OF. Our case is of particular interest because it is, to our knowledge, the first documented case of OF arising from the middle turbinate.
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Affiliation(s)
- Fatma Caylakli
- Deparment of Otorhinolaryngology, Baskent University, Ankara, Turkey.
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Cansiz H, Tuskan K, Karaman E, Dervisoğlu S. Endoscope assisted removal of cementoossifying fibroma in the paranasal sinuses in a five-year-old girl. Int J Pediatr Otorhinolaryngol 2004; 68:489-93. [PMID: 15013618 DOI: 10.1016/j.ijporl.2003.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2003] [Revised: 11/05/2003] [Accepted: 11/09/2003] [Indexed: 10/26/2022]
Abstract
We report a five-year-old girl with a sinonasal cementoossifying fibroma with CT findings that reveal the invasion of all paranasal sinuses and the remodeling of facial bones. It was possibly a congenital lesion and caused a slowly progressive nasal obstruction and anosmia. Tumor removal with transnasal endoscopic approach was applied and total removal of the mass was accomplished. It was found out to be the cementoossifying fibroma of the paranasal sinuses when the results of the pathological examinations were obtained.
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Affiliation(s)
- H Cansiz
- Otorhinolaryngology and Head & Neck Surgery, Department of Cerrahpasa Medical School, Istanbul, Turkey.
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