Türk Nöroşirürji Dergisi 2008 , Vol 18 , Num 1
Ethmoidal Osteoma with an Intraorbital Extension Presenting Proptosis and Visual Symptoms: Case Report
Ahmet ÇETİNKAL, Murat KUTLAY, Ahmet ÇOLAK, Hakan ŞİMŞEK, Alparslan AŞIR, Ali Kıvanç TOPUZ, Mehmet Nusret DEMiRCAN
GATA Haydarpaşa Eğitim Hastanesi, Nöroşirürji Servisi, İstanbul OBJECTIVE: Ethmoidal sinus osteomas are slow growing, benign, capsulated bone tumors causing earlier symptoms when comparing to other paranasal sinus osteomas. Their orbital involvements are uncommon. Although mostly having an asymptomatic course, they may also present with facial pain, rhinorrhea, anosmia, sinusitis, and ocular symptoms, mainly proptosis.

CASE REPORT: 28-year-old male patient referred with 3 years history of left sided ocular symptoms, including progressive proptosis and visual field defect. Roentgenograms and computed tomography demonstrated a hyperdense mass lesion, an osteoma originating from ethmoidal sinus, extending into left orbit. Orbital magnetic resonance imaging revealed its detailed extention from upper side of medial rectus muscle to inferomedial aspect of the superior rectus muscle and medially to optic nerve. The lesion was removed away completely via transcranial approach.The postoperative course was uneventful with total recovery of the symptoms within one year period after surgery.

DISCUSSION and RESULTS: Osteomas are the most common tumors of nasal and paranasal sinuses. They are clinically asymptomatic in most cases and detected incidentally by plain sinus roentgenograms, computed tomography with the rates of 1% and 3% respectively. The lesions presenting with several symptoms, previously defined in the literature according to their locations and extensions, are removed via open surgical and/ or endoscopic approaches. Anahtar Kelimeler : Osteoma, Orbit, Ethmoid sinus, Surgery