Surgical tactics for osteomas of the paranasal sinuses in the practice of an otorhinolaryngologist
- Authors: Ovchinnikov A.Y.1, Edzhe M.A.1, Marasanova E.V1
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Affiliations:
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry
- Issue: Vol 28, No 10 (2021)
- Pages: 74-78
- Section: Articles
- URL: https://journals.eco-vector.com/2073-4034/article/view/313258
- DOI: https://doi.org/10.18565/pharmateca.2021.10.74-78
- ID: 313258
Cite item
Abstract
Background. Osteoma is a slowly growing tumor of bone tissue. This is the most common benign neoplasm of the nasal cavity and paranasal sinuses, which is detected in 3% of the population. Osteomas located in the frontal sinuses, the roof of the ethmoid labyrinth and the frontal pocket are usually clinically more significant than other localizations due to the tendency to block the nasolabial anastomosis, spread into the orbit or cranial cavitY., which leads to complications. In this case, when choosing treatment tactics, preference should be given to the complete surgical removal of the neoplasm. Methods with external approach and endoscopic endonasal methods are used for the treatment. Objective. Assessment of the efficacy and safety of the endoscopic endonasal method for removing the ethmoidal labyrinth osteoma adjacent to the skull base. Methods. The study included 17 patients with a diagnosis of PNS osteoma, who were treated in the Otorhinolaryngology Department of the Clinical Medical Center. The group consisted of 7 men and 10 women. In 9 (52.9%) patients, the osteoma was localized in the ethmoidal sinus. All patients underwent surgical removal of the osteoma. In the vast majority of patients - 14 (82.3%), the tumor was removed using the endoscopic transnasal approach. In 3 (17.6%) cases of giant frontal sinus osteomas, an external approach was used. Results. There were no complications during the inpatient stage; the postoperative period was uneventful. The clinical condition improved in all patients. No tumor recurrence was observed in any of the cases. Conclusion. The transnasal endoscopic approach for PNS osteomas is the method of choice for tumors up to 3 cm in diameter, localized in the ethmoidal labyrinth, on the inferolateral wall of the maxillary sinus and on the posterior wall of the frontal sinus near its anastomosis. The method allows for total removal of the tumor, safe controlled surgery in terms of blood loss and damage to critical neurovascular structures and provides a good cosmetic effect.
Full Text
About the authors
A. Yu Ovchinnikov
A.I. Yevdokimov Moscow State University of Medicine and Dentistry
Maya A. Edzhe
A.I. Yevdokimov Moscow State University of Medicine and Dentistry
Email: ayam75@mail.ru
Cand. Sci. (Med.), Associate Professor at the Department of Otorhinolaryngology
E. V Marasanova
A.I. Yevdokimov Moscow State University of Medicine and Dentistry
References
- Перич Б. Остеомы носа и околоносовых пазух (обзор литературы) Медицинский центр Кварнсведен, Борленге, Швеция
- Осипенко Е.В., Карпищенко С.А., Сопко О.Н., Верещагина О.Е. Компьютерная томография в диагностике остеом околоносовых пазух. Лучевая диагностика и терапия. 2014;(4):68-73
- Болознева Е.В. Эндоскопическая эндоназальная хирургия остеом околоносовых пазух 2017. Дисс. канд. мед. наук. СПб., 2017
- Трусов Д.В., Бычкова М.В., Чикин А.В. Наблюдение трех больных с гигантскими остеомами околоносовых пазух. Вестник Тамбовского университета. Серия Естественные и технические науки. 2017;22(6):1593-97
- Носуля Е.В, Перич Б., Ким И.А. Доброкачественные опухоли и опухолеподобные заболевания носа и околоносовых пазух. Учебное пособие Минздрава РФ ФГБОУ ДПО Российская медицинская академия непрерывного профессионального образования. М., 2018
- Namdar I., Edelstein D.R., Huo J., et al. Management of osteomas of the paranasal sinuses. Am J Rhinol.1998;12(6):393-98.
- Koivunen Fl, Löppönen H., Fors A.P., Jokinen K. The growth rate of osteomas of the paranasal sinuses. Clin Otolaryngol Allied Sci. 1997;22(2):111-14 doi: 10.1046/j.1365-2273.1997.00869.x.
- Pons Y., Blancal J.P., Verillaud B., et al. Ethmoid sinus osteoma: diagnosis and management. Head Neck. 2013;35(2):201-4. Doi: 10.1002/ hed.22945.
- Cokkeser Y. et al. Our experience with the surgical management of paranasal sinus osteomas. Eur Arch Otorhinolaryngol. 2013;1:123-28. doi: 10.1007/s00405-012-1981-z.
- Georgalas C., Goudakos J., Fokkens W.J. Osteoma of the skull base and sinuses. Otolaryngol. Clin North Am. 2011;44(4):875-90. Doi: 10.1016/j. otc.2011.06.008.
- Halawi A.M., Maley J.E., Robinson R.A., et al. Craniofacial osteoma: clinical presentation and patterns of growth. Am J Rhinol Allergy 2013;2 7(2): 128-33. Doi: 10.2500/ ajra.2013.27.3840.
- Strek P., Zagolski O., Wywiai A., et al. Osteoma of the sphenoid sinus. B-ENT. 2005;1(1):39-41.
- Muderris T., Bercin S., Sevil E., Kiris M. Endoscopic removal of a giant ethmoid osteoma with orbital extension. Acta Inform Med. 2012;20(4):266-doi: 10.5455/aim.2012.20.266-268.
- Banks C.G., Garcia J.A.P., Grayson J., et al. Osteoplastic Flap Without Obliteration: How I Do It. Am. J. Rhinol. Allergy. 2018;32(5):346-49. doi: 10.1177/1945892418782222.
- Smith M.E., Calcaterra T.C. Frontalsinus osteoma. Ann Otol Rhinol Laryngol. 1989;98(11):896-900.
- Castelnuovo P., Valentini V., Giovannetti F., et al. Osteomas of the maxillofacial district: endoscopic surgery versus open surgery J Craniofac Surg. 2008;19:1446-52.
- Cheng, K.J., Wang, S.Q., Lin L. Giant osteomas of the ethmoid and frontal sinuses: Clinical characteristics and review of the literature. Oncol Letters. 2013;5(5):1724-30. Doi: 10.3892/ ol.2013.1239.
- Lund V.J., Stammberger H., Nicolai P., et al. Management of Nose, Paranasal Sinus and Skull Base Tumours. European position paper on endoscopic management of tumours of the nose, paranasal sinuses and skull base. Rhinol. Suppl. 2010;22:1-143.
- Cheng K., Wang S., Lin L. Giant osteomas of the ethmoid and frontal sinuses: Clinical characteristics and review of the literature. 2013;5:1724-30. doi: 10.3892/ol.2013.1239.
- Turri-Zanoni M., Dallan I., Terranova P., et al. Frontoethmoidal and Intraorbital Osteomas: Exploring the Limits of the Endoscopic Approach. Arch Otolaryngol Head Neck Surg. 2012;138(5):498-504. doi: 10.1001/archoto.2012.644.
- Nguyen S., Nadeau S. Giant Frontal Sinus Osteomas: Demographic, Clinical Presentation, and Management of 10 Cases. Am J Rhinol Allergy. 2019);33(1):36-43. doi: 10.1177/1945892418804911.
- Silverman J.B., Gray S.T., Busaba N.Y., Role of Osteoplastic Frontal Sinus Obliteration in the Era of Endoscopic Sinus Surgery Int J Otolaryngol. 2012; 2012:501896. doi: 10.1155/2012/501896.
- Eledeissi A., Ahmed M., Helmy E. Frontal Sinus Obliteration Utilizing Autogenous Abdominal Fat Graft. Open Access Maced J Med Sci. 2018;6(8):1462-67. Published 2018 Jul 21. doi: 10.3889/oamjms.2018.295.
- Aitasalo K.M.J, Peltola M.J. Bioactive glass hydroxyapatite in fronto-orbital defect reconstruction. Plast Reconstr Surg. 2007;120(7):1963-72. doi: 10.1097/01. prs.0000287319.34425.27.
- Sittitavornwong S., Morlandt A.B. Reconstruction of the scalp., calvarium, and frontal sinus. Oral Maxillofac. Surg Clin North Am. 2013;25(2):105-doi: 10.1016/j.coms.2013.02.004.