The bicoronal approach for the treatment of a large frontal sinus osteoma. A technical note.

abstract not available Paper introduction: ...Osteoma represents the most common benign neoplasm of the nose and paranasal sinuses. The frontal sinus is the most frequent localization of osteoma in paranasal sinuses, with an incidence ranging from 37% to 80% of the cases, (followed by the ethmoid, maxillary, and sphenoid sinuses, respectively) and a predilection for the fifth and sixth decades (male-female ratio, 1.3:1) [1-4]. Thirty-seven percent of the cases of frontal osteoma involve the rhinofrontal duct, and 21% involve the superior-lateral side of the rhinofrontal ostium [5]. Tumor mean diameter may vary from 1.5 to 30 mm. Sinonasal osteoma growth is usually very slow and may take many years to become clinically evident. Nevertheless, it may be locally aggressive, with displacement of anatomic structures and possible intracranial involvement such as rhinoliquorrhea, pneumoencephalus, and intracranial infection [6]. Osteoma of the frontal sinus often requires a surgical treatment that depends on patient symptoms; tumor size, course, and location; and complications. Asymptomatic patients can be managed conservatively or submitted to surgery regardless of the location or extent of the tumor. Facial pain, facial deformity, and headache are symptoms that indicate a surgical approach. The growth rate of this benign tumor is very slow, but when its size provokes obstruction of the sinus ostia, extension into adjacent bones, intracranial cavity, and displacement of anatomic structures, the surgical approach is mandatory [7,8]. The present report describes the results of a bicoronal approach for the radical excision of a large frontal sinus osteoma. The results of this technique are compared with those of other surgical approaches...