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Frontal osteomas: standardising therapeutic indications

Published online by Cambridge University Press:  18 July 2011

L M Gil-Carcedo ,
E S Gil-Carcedo ,
L A Vallejo ,
J M de Campos  and
D Herrero
L M Gil-Carcedo*
Affiliation:
Department of Otolaryngology, Rio Hortega Hospital, Valladolid University Hospital, Valladolid University, Spain
E S Gil-Carcedo
Affiliation:
Department of Otolaryngology, Rio Hortega Hospital, Valladolid University Hospital, Valladolid University, Spain
L A Vallejo
Affiliation:
Department of Otolaryngology, Rio Hortega Hospital, Valladolid University Hospital, Valladolid University, Spain
J M de Campos
Affiliation:
Department of Neurosurgery, Jimenez Diaz Foundation Hospital, Autonomous University of Madrid, Spain
D Herrero
Affiliation:
Department of Otolaryngology, Rio Hortega Hospital, Valladolid University Hospital, Valladolid University, Spain
*
Address for correspondence: Dr Luis M Gil-Carcedo, Calle Teresa Gil 16, 3°, 47002 Valladolid, Spain Fax: +34 983 306231 E-mail: gilcarsa@telefonica.net
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Abstract

Background:

We believe the currently accepted indications for frontal osteoma surgery are inappropriate. We propose a new osteoma classification system, below, in order to standardise surgical decisions.

Method:

Osteomas were classified based on: relationship of tumour mass to sinus size; tumour proximity to the infundibulum, destruction of sinus walls, and complications. Forty-five osteoma cases were thus classified (1971–2007), 29 of which underwent surgery (64.44 per cent).

Results:

Three stages were thus derived: I, tumour/air fraction less than one-third, tumour distant from the infundibulum, no sinusitis, and no complications (18 patients (40 per cent)); II, tumour/air fraction one-third to one-half, no infundibular obstruction, no bone destruction, no sinusitis, and no complications (six (13.33 per cent)); and III, tumour/air fraction more than one-half, partial or total infundibular obstruction, sinusitis, bone destruction, and/or complications (21 (46.67 per cent)).

Conclusion:

Study findings suggest the following surgical indications: stage I, no surgery required, implement monitoring protocol; stage II, implement monitoring protocol, surgery may be required depending on tumour severity and general patient condition; and stage III, surgery always required. This system provides a method of standardising osteoma surgical decisions.

Keywords

Paranasal SinusesOsteomasFrontal SinusSurgical Therapy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 10 , October 2011 , pp. 1020 - 1027
Copyright
Copyright © JLO (1984) Limited 2011

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