Endonasal Endoscopic Resection of Giant Ethmoido-Orbital Osteoma with Intra Orbital Extension
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- Category: Vol. 77, June 2009
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Endonasal Endoscopic Resection of Giant Ethmoido-Orbital Osteoma with Intra Orbital Extension,ASHRAF M. KHALED
Abstract
Objective: Osteoma is a benign, osteogenic tumor that usually grows slowly and asymptomatically. Giant ethmoido-orbital osteoma is a rare event that can give rise to ocular signs and symptoms; in such a case treatment is mandatory, although debates persist regarding the optimal approach.
Methods: Between 1999 and 2007, six patients (four men and two women) with giant ethmoido-orbital osteomas were treated using endonasal endoscopic approach. Their ages ranged from 17 to 63 years (mean 46.3 yr). All procedures were performed under general anaesthesia using 0° and 30° nasal endoscopes. The osteoma was fragmented using intra-nasal drill and then the divided parts were detached from surrounding structures and pulled out of the nose. Finally the surgical site was packed.
Results: The transnasal endoscopic approach was successful in all six patients. Follow up period ranged from 12 months-8 years (mean 46 months). There were no major complications and only one patient had postoperative persistent epiphora which was treated by endoscopic DCR and insertion of silicon tube.
Conclusion: In selected cases of ethmoido-orbital osteo-mas, endonasal endoscopic approach provides a safe and effective alternative to open approaches, offering cosmetic advantages and lowering the morbidity.