Suggest Treatment For Sinus Osteoma

Posted on Mon, 23 Nov 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 23 Nov 2015 Answered on

Mon, 21 Dec 2015 Last reviewed on

Question : Hello,

I have an osteoma, about 3/4", growing in the sinus between my eyes. It hasn't totally blocked the canal and seems to be growing slowly. The ENT specialist intends to not use an endoscope, will cut through from the eye socket then open up and remove it. The osteoma is attached at the back of the sinus, against the brain. I'm concerned about his lack of technological expertise, or maybe he has the right approach. Would this suggest a second opinion?

Answered by Dr. Sumit Bhatti (54 minutes later)

Brief Answer:
Asymptomatic osteoma should be left alone.

Detailed Answer:
Hi,

Thank you for your query.

1. Asymptomatic sinus osteoma should be observed and not operated. Upload Sinus CT images for a better assessment.

2. Currently an endoscopic drill out and a combined approach is done. Only external approaches are rarely used.

3. Most frontoethmoid osteoma are incidental findings. They are benign and do not recur after surgery.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumit Bhatti (19 minutes later)

Ok, thanks. The dr. will drill it out after he gets in there but he seems concerned about where it is attached and its size. I suggested leaving it but he says I'm leaving myself open to infection getting trapped behind it and says if it has to come out in 5 or 6 years my age will be against me. I also have a deviated septum from a fairly serious incident 5 years ago that resulted in concussion, laceration, broken nose and damaged sinus. He says he'll repair the nose at the same time. He also says I'll need plastic surgery to repair the scar later. What do you think?

Answered by Dr. Sumit Bhatti (7 hours later)

Brief Answer:
The exact location of the osteoma is important.

Detailed Answer:
Hi,

Thank you for writing back.

1. Again, the repair of a DNS (Deviated Nasal Septum) depends upon whether there are any symptoms. Asymptomatic DNS does not require any intervention.

2. The trauma does seem to be the reason for the osteoma.

3. Uploading the CT Scan images will be useful in planning treatment.

4. The argument regarding possible future sinus obstruction is valid, especially in the frontal sinus. However these osteomas are extremely slow growing and may never cause a problem. The exact location of the osteoma is important. A few years later should not cause any problem for an endoscopic procedure.

5. An endoscopic procedure will not require a plastic surgery scar revision.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumit Bhatti (13 hours later)

Thank you, this is helpful.

Answered by Dr. Sumit Bhatti (29 minutes later)

Brief Answer:
WWishing you good health.

Detailed Answer:
Hi,

Thank you for writing back.

Wishing you good health.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar