For the Medical Practitioners
doi: 10.25005/2074-0581-2022-24-2-254-264
GIANT FRONTOETHMOIDAL OSTEOMAS: A RATIONAL APPROACH TO THE SURGICAL REMOVAL AND THE IMMEDIATE RECONSTRUCTION OF THE ANTERIOR WALL OF THE FRONTAL SINUS

M.K. Ikromov

Department of ENT Diseases, Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan, Dushanbe, Republic of Tajikistan

Objective: To develop an appropriate method for removing giant frontoethmoidal osteomas and the immediate reconstruction of the anterior wall of the frontal sinus.

Methods: Between 2016 and 2020, five patients (4 men and 1 woman) were admitted with an osteoma of the paranasal sinuses, of which three (2 men and 1 woman) were diagnosed with giant osteomas of the frontal and ethmoid region. The patients were aged 28 to 49 years. Routine clinical examinations were carried out, including collecting patient history and a CT scan of the paranasal sinuses. The giant osteomas were removed by minimally invasive transnasal endoscopic surgery with a combined anterior wall approach to the frontal sinus. The tumour size was reduced by excision with a surgical drill before removal to minimise the defect in the frontal sinus's anterior wall. The procedure was completed with the immediate reconstruction of the anterior wall of the frontal sinus using titanium nickelide mesh.

Results: The length of hospital stay was 10 days. Wound healing occurred by primary intention, and the sutures were removed on the 8th day. Followup periods were between 1 month and 1 year. Follow-up examinations were carried out 1 week, 1, 6 and 12 months after hospital discharge. On the follow-up CT scans performed a year after the operation, the implanted titanium nickelide mesh was stable, the aeration of the frontal sinus was normal, and satisfactory cosmetic outcomes were reported.

Conclusion: CT is the gold standard in determining the size of the osteoma, its spread, and the state of the walls of the paranasal sinuses. A combined surgical approach and debulking of the giant osteomas using a surgical drill with the immediate reconstruction of the anterior wall of the frontal sinus by titanium nickelide mesh produce favourable outcomes.

Keywords: Osteoma, benign tumour, frontal sinus, surgical treatment, frontal recess, titanium nickelide mesh.

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References
  1. Balakina LB, Naumenko AN, Konoplyov OI, Gaydukov SS, Naumenko NN. Transnazal'nyy dostup s ispol'zovaniem endovideotekhniki pri udalenii osteom lobnykh pazukh [Experience of transnasal endoscopic approach in excision of the frontal sinusosteomas]. Rossiyskaya otorinolaringologiya. 2016;3:33-8. Available from: https://doi.org/10.18692/1810-4800-2016-3-33-38
  2. Shamsidinov BN. Bemorihoi gushu gulu va bini [Diseases of the ear, throat and nose]. Dushanbe, RT: Kontrast; 2013. 863 p.
  3. Vigand ME. Endoskopicheskaya khirurgiya okolonosovykh pazukh i perednego otdela osnovaniya cherepa [Endoscopic surgery of the paranasal sinuses and anterior skull base]. Moscow, RF: Meditsinskaya literatura; 2014. 277 p.
  4. Karpishchenko SA, Vereshchagina OE, Osipenko EV. Dobrokachestvennye novoobrazovaniya okolonosovykh pazukh [Benign neoplasms of the paranasal sinuses]. Prakticheskaya meditsina. 2015;2:104-8.
  5. Balakina LB, Naumenko AN, Anikin IA, Matveev K.A, Naumenko NN. Sposob udaleniya osteomy iz bikoronarnogo dostupa s odnomomentnoy rekonstruktsiey defekta stenok lobnoy pazukhi [The method of osteomas removal from bikoronar approach with the access following reconstruction of the frontal sinus wall defect]. Rossiyskaya otorinolaringologiya. 2015;3:9-14.
  6. Karpishchenko SA, Bolozneva EV. Endoskopicheskaya endonazal'naya khirurgiya osteom okolonosovykh pazukh [Endoscopic endonasal surgery for osteomas of the paranasal sinuses]. Vestnik otorinolaringologii. 2016;4:42-4. Available from: https://doi.org/10.17116/otorino201681442-44
  7. Berbom K, Kashke O, Navka T, Sift E. Bolezni ukha, gorla i nosa [Diseases of the ear, throat and nose]. Moscow, RF: MEDpress-inform; 2012. 772 p.
  8. Matveev KA, Naumenko AN, Chernushevich II, Naumenko NN. Udalenie osteom lobnoy pazukhi putyom osteoplasticheskoy frontotomii s ispol'zovaniem bikoronarnogo dostupa [Removal of the frontal sinus osteoma by osteoplastic frontotomy using bicoronal approach]. Rossiyskaya otorinolaringologiya. 2012;6:100-5.
  9. Balakina LB, Naumenko AN. Sovremennye khirurgicheskie podkhody v lechenii osteom lobnykh pazukh [Modern surgical approaches to the treatment of frontal sinus osteoma]. Rossiyskaya otorinolaringologiya. 2014;1:3-8.
  10. Gaydukov SS, Balakina LV, Naumenko AN. Osobennosti endoskopicheskogo udaleniya gigantskikh osteom okolonosovykh pazukh, soprovozhdayushchikhsya destruktsiey kostnykh struktur perednego otdela osnovaniya cherepa [Methods of endoscopic giant osteomas removal with anterior skull base defects]. Rossiyskaya otorinolaringologiya. 2015;3:27-32.
  11. Dzhamaludinov YuA, Gadzhimirzaev GA, Shakhnazarov AM, Dzhamaludinova PYu, Gadzhimirzaeva RG. Analiz 42 nablyudeniy osteomy okolonosovykh pazukh [The analysis of 42 observations of paranasal sinus osteoma]. Vestnik otorinolaringologii. 2016;5:23-6. Available from: https://doi.org/10.17116/ otorino201681523-26
  12. Ikromov MK, Davlatov DSh, Nazirmadova MB, Abdukhalilov AA. Otsenka effektivnosti endoskopicheskoy sinusotomii pri khronicheskikh polipoznykh rinosinusitakh po dannym LOR kliniki GU « NMTs» RT [Evaluation of the effectiveness of endoscopic sinusotomy in chronic polyposis rhinosinusitis according to the ENT clinic of the State Institution "NMC" of the Republic of Tajikistan]. Vestnik Avitseny [Avicenna Bulletin]. 2017;19(1):63-7. Available from: https://doi. org/10/25005/2074-0581-2017-19-1-63-67
  13. Shamsidinov BN, Mukhiddinov ND, Mukhtorova PR. Jarrokhiyai amaliyotii gush, gulu, bini va digar a"zokhoi saru gardan [Operations on the ear, throat, nose, and other organs of the head and neck]. Dushanbe, RT: Ofset-Imperiya; 2018. 543 p.
  14. Cheng KJ, Wang SQ, Lin L. Giant osteomas of the ethmoid and frontal sinuses: Clinical characteristics and review of the literature. Oncol Lett. 2013;5:1724-30. Available from: https://doi.org/10.3892/ol.2013.1239
  15. Samue II. Endoscopic brow approach for frontal osteoma in a pediatric patient. International Journal of Pediatric Otorhinolaringology. 2012;76(8):1211-3. Available from: https://doi.org/10.1016/j.ijporl.2012.04.011
  16. Alotaibi N. Endoscopic removal of large orbito-ethmoidal osteoma in pediatric patient. International Journal of Pediatric Otorhinolaringology. 2013;4(12):1067-70. Available from: https://doi.org/10.1016/j. ijscr.2013.07.035
  17. Khushvakhtov DI, Shakirov MN, Mirzoev MSh. Sovershenstvovanie khirurgicheskikh metodov lecheniya bol'nykh s nagnoivshimisya odontogennymi kistami chelyustey s ispol'zovaniem poristykh granul iz nikelida titana [Improvements of surgical methods of treatment of patients with suppressed odontogenic cysts of the jaw with the use of porous granules of titanium nickel]. Vestnik poslediplomnogo obrazovaniya v sfere zdravookhraneniya. 2017;3:54-8.
  18. Mirzoev MSh. Sovremennyy vzglyad na razlichnye materialy dlya zameshcheniya defektov kostey litsevogo skeleta [Modern look at different materials for the replacement of defects of the skeletal bone]. Vestnik poslediplomnogo obrazovaniya v sfere zdravookhraneniya. 2017;3:83-9.
  19. Gyunter VE. Materialy i implantaty s pamyat'yu formy v meditsine [Materials and implants in memory of forms in medicine]. Tomsk, RF: MITs; 2014. 342 p

Authors' information:

Ikromov Makhmadulo Kurbonovich
Candidate of Medical Sciences, Assistant of the Department of ENT Diseases, Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan
ORCID ID: 0000-0002-5364-362Х
E-mail: ikromov.mk-71@mail.ru

Information about support in the form of grants, equipment, medications

The author did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Ikromov Makhmadulo Kurbonovich
Candidate of Medical Sciences, Assistant of the Department of ENT Diseases, Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan

734026, Republic of Tajikistan, Dushanbe, Somoni Ave., 59

Tel.: +992 (918) 530898

E-mail: ikromov.mk-71@mail.ru

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  2. DELAYED RECONSTRUCTIVE SURGERY FOR SEVERE HAND INJURIES
  3. SURGICAL MANAGEMENT OF POST-BURN SCAR EXTENSION CONTRACTURES OF THE TOES
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  10. THE OUTCOMES OF THE FOREARM FLAP APPLICATIONS IN THE UPPER LIMB SEVERE INJURIES RECONSTRUCTION

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