Giant Frontal Sinus Osteoma with Orbital Extension: Case Report and Review of Literature

Aim: The authors hereby present a case of giant frontal osteoma, i.e., not so rare but in the present case, the size and orbital involvement of this tumor make it a unique case. Introduction: Paranasal sinus osteoma most commonly presents in frontal sinuses. Their growth is slow, and patients usually seek physician’s advice only for cosmetic reasons. Case description: A 20-year-old male presented to us with the complaint of swelling over forehead and medial side of left eye for last 1 year. After investigations, he was diagnosed with frontal osteoma, which was excised en bloc using bicoronal approach. There was a dural tear and cerebrospinal fluid (CSF) leak intraoperatively, which was managed using pericranial flap. He remained free of disease in 2 years of follow-up. Conclusion: Frontal sinus osteomas are slow-growing bony tumors, which are amenable to complete cure provided adequate preoperative planning and meticulous surgical technique are used. Clinical significance: This case highlights the need for outreach of tertiary care to remote areas where medical facilities are scarce. Patients usually visit the apex hospitals only when the disease has grown significantly. The authors also would like to reiterate that computed tomography (CT) scan is the best modality for the diagnosis of paranasal osteoma. Small dural tears, if encountered during removal of large osteomas, can be repaired using pericranial flap.