Papilloma sinus mri, Specificații


Figure 5. Drainage tube through the frontal recess The histopathologic examination confirmed the diagnosis of left frontal sinus osteoma. The postoperative evolution was favorable.

The patient received i. Daily dressing change was performed, as well as aspiration through and around the drainage tube. The postoperative ENT reevaluation was performed after 14 days Figure 6at one month, at three months, and at six months. Figure 6. ENT reevaluation at 14 days after surgery Discussion Osteoma is the most common tumor of paranasal sinuses, often with a slow and silent evolution. The most papilloma sinus mri involved site is frontal sinus, followed by ethmoid and maxilar sinuses.

The sphenoid sinus is rarely involved 1,2. In general, the papilloma sinus mri of osteomas may vary papilloma sinus mri 2 and 30 mm. Osteomas bigger than 30 mm or the ones weighing more than g are considered to be giant 4. The etiology of osteomas is still unknown.

Several hypotheses have been taken into consideration: traumatic or infectious triggers, calcium metabolism disorders, or embryonic malformations 5.

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Frontal sinus osteoma grading system 6 Grade I. The base of attachment is posterior-inferior along the frontal recess. The tumor is medial to a virtual sagittal plane through the lamina papyracea. Grade II. Grade III.

papilloma sinus mri

Grade IV. Tumor fills the entire frontal sinus the current case.

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Osteomas papilloma sinus mri white, hard, well circumscribed, round or oval, sesile rarely pediculatedbosselated tumors. Histologically, osteoma is composed of lamellar, mature bone with haversian-like systems, surrounded by fibrous, paucicellular stroma 7.

Polipoză de sinus frontal operată prin abord endoscopic transcranian

The diagnosis of osteoma is established by clinical and paraclinical exams. The patients may complain of persistent frontal pain unresponsive to analgesic or antiinflammatory medication, hemifacial pain, rhinoreea and nasal obstruction.

Computed tomography of the head and paranasal sinuses is the gold standard for the diagnosis of oste­oma and is also papilloma sinus mri for its management. MRI is useful when intracranial extensions papilloma sinus mri suspected 8. The papilloma sinus mri of the frontal sinus osteoma depends on the severity of laryngeal papillomatosis causes symptoms and the extension of the tumor.

If chronic sinusitis unresponsive to treatmentpersistent headaches when all other causes have been excluded or mucocele occur, the therapeutic approach is surgical. It can be external, endoscopic or combined: external for the removal of the papilloma sinus mri, and endoscopic to provide the appropriate drainage from the frontal sinus.

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The approach depends mostly on the site and dimension of the osteoma. Sometimes, there are cases of small frontal recess osteomas which can be approached only by endoscopic approach.

Polipoză de sinus frontal operată prin abord endoscopic transcranian

The definitive diagnosis of osteomas can be established only after the histological examination of the tumor. If osteoma is big, extending through the sinus wall to the intracranial space, a multidisciplinary surgical approach will be mandatory: otorhinolaryngologist and neurosurgeon.

The postoperative complications which may occur are: subcutaneous emphysema, persistent suppurative sinusitis, fistulization, frontal osteomyelitis, papilloma sinus mri nerve branches damage, supraorbitar neuralgia, ecchymosis, palpebral edema, dyplopia, epiphora, frontal recess stenosis, recurrence of frontal sinusitis, and tumoral recurrence.

The current case had a classic, slow onset and progression, affecting a middle aged female patient. The symtoms have occured gradually: progressive headache  started 12 months before the admission to the hospital. The presumptive diagnosis was established papilloma sinus mri clinical and paraclinical examinations transnasal endoscopy, native computed tomography of the head and paranasal sinuses.

Frontal sinus osteoma – case report

The definitive diagnosis was established by the histological examination of the tumor. Considering the size of the tumor 4th grade, taking into consideration the classification of osteomas mentioned abovethe decision regarding the papilloma sinus mri approach was taken and the combined approach surgery was performed: external and endoscopic, which allowed the ablation of the tumor, as well as proper postoperative drainage of frontal sinus.

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Due to the early diagnosis of the osteoma, no complications have been noticed, the evolution being favorable. ENT postoperative reevaluations performed after one month, three months, six months and 12 months did not reveal any tumoral recurrence. Conflict of interests: The authors declare no conflict of interests. Paranasal sinus osteomas. J Craniofac Surg. Osteoma of the skull base and sinuses. Otolaryngol Papilloma sinus mri North Am.

Savastano M, et al.

Nsa.

Head and Neck Medicine and Surgery. American Journal of Otolaryngology. Izci Y. Management of the large cranial osteoma: experience with 13 adult patients. Acta Neurochir Wien. Our experience with the surgical management of paranasal sinuses osteomas. Eur Arch Otorhinolaryngol. American Journal of Rhinology.

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Head Neck Pathol. Osteomas of the Maxillofacial District.

The endoscopic approach was performed through a small bone window by the midline of the glabella, with the restoration of the bone support at the end of the surgery using a titanium mesh. Although the surgical staff has a lot of experience in doing the endoscopic transnasal approach, there are some cases where the transnasal route cannot safely solve certain pathologies. This is the reason why the authors wish to illustrate the need of using an approach papilloma sinus mri will ensure a proper management of any kind of complications that can occur during surgery, specific to these tumors bleeding, cerebrospinal fluid leak. In this case, the transcranial endoscopic approach was the best solution. Keywords frontal sinus, tumor, external endoscopic approach Rezumat Prezentăm cazul unui pacient, în vârstă de 62 de ani, cu o formaţiune tumorală voluminoasă de sinus frontal bilateral, cu sindrom cefalalgic sever şi distrucţia parcelară a laminei papiracee stângi şi a peretelui papilloma sinus mri al sinusului frontal drept.

Journal of Craniofacial Surgery. Bacalbaşa A.

Frontal sinus osteoma – case report

Cazuri rare în otorinolaringologie, Ed. Medic Art, Bucureşti, Turk Arch Otorhinolaryngol. Frontoethmoidal and intraorbital osteomas: exploring the limits of the endoscopic approach. Arch Otolaryngol Head Neck Surg.