Surgical tactics for osteomas of the paranasal sinuses in the practice of an otorhinolaryngologist

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.

ethmoidal labyrinth osteoma, endoscopic endonasal surgerY, computed tomography