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Inicio Acta Otorrinolaringológica Española Isolated osteoma of the sphenoid sinus
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Vol. 68. Núm. 3.
Páginas 131-190 (Mayo - Junio 2017)
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Vol. 68. Núm. 3.
Páginas 131-190 (Mayo - Junio 2017)
Images in Otorhinolaryngology
DOI: 10.1016/j.otorri.2016.02.011
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Isolated osteoma of the sphenoid sinus
Osteoma aislada del seno esfenoidal
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Ramanuj Sinha, Neeraj Aggarwal, Mainak Dutta
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duttamainak@yahoo.com

Corresponding author.
Department of Otorhinolaryngology and Head-Neck Surgery, Medical College and Hospital, Kolkata, West Bengal, India
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A 16-year-old boy presented with clinical features suggestive of chronic rhinosinusitis. Diagnostic naso-endoscopy showed congested nasal mucosa and mucopus in the middle meati. The remaining areas of interest including the spheno-ethmoid recesses were unremarkable. A non-contrast computed tomography (CT) following three weeks of antibiotics and topical nasal steroids showed resolution of the sinonasal infection. Interestingly, a large radiodense lesion was noted involving predominantly the posterior aspect of the right sphenoid sinus, extending to the left (Fig. 1A–F). Follow-up naso-endoscopy revealed patent sphenoid ostia with disease-free spheno-ethmoid recesses. The lesion had similar density with that of bone, and was considered an isolated osteoma of the right sphenoid sinus.

(0,57MB).

Osteomas are the commonest benign neoplasms of nose and paranasal sinuses, mostly involving the fronto-ethmoid region. However, an isolated osteoma of the sphenoid is extremely rare and is mostly detected incidentally during radiologic examination indicated for other reasons. Although the osteoma in our patient was large, its relative posterior location and consequent sparing of the ostium could explain why the sinus was not involved in the inflammatory process. In fact, a sphenoid osteoma blocking the ostium might result in sinusitis with endoscopically-evident sinus mucocele or polyp in the spheno-ethmoid recess. It may also produce deep-seated headache, and can occasionally be fast-growing resulting in visual disturbances. Unlike the fronto-ethmoid osteomas, there is no given protocol for management of a sphenoid osteoma due to dearth of clinical reports. Since it mostly remains asymptomatic, there might be gross underreporting. Available clinical evidence suggests watchful observation in an incidentally-discovered, asymptomatic sphenoid osteoma. In rare instances when it becomes symptomatic, it needs to be excised by endoscopic, open or combined approaches.

Financial disclosure

None declared.

Conflict of interest

None declared.

Copyright © 2016. Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello
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