A retrospective analysis was done in 19 patients (15 male, 4 female, aged between 14 - 67, medium 37) diagnosed as
osteomas of ethmoid sinuses hospitalized from April 2005 to October 2009. All patients underwent sixteen-detector row computed tomography scan and 3D reconstruction preoperatively. All underwent operation with the help of navigation system and nasal
endoscope.
RESULTS: The ethmoid
osteoma in all 19 patients was removed successfully with
endoscope and navigation system. Two open procedures (1 through superciliary arch incision and 1 through labiogingival incision) were performed to assist the removal of the
tumor, 17
tumors were removed under endoscopic and navigation guidance. In 5 patients whose
osteoma was localized or with the diameter no more than 2 cm, these
osteomas were removed endonasally with the help of navigation system. The
osteomas in 2 patients was found to have narrow basilar part and relatively dissociative were removed from oral cavity after abscisin the basilar part. The
osteomas in 12 patients were found to have basilar part connected with ante-meso skull base, lamina papyracea, orbital apex, cranialis opticus, fossa orbitalis bone, these
osteomas were removed using electric drill with the guidance of navigation system. All patients were followed up from 8 to 64 months, and were asymptomatic (1 patient who suffered from
amblyopia had the symptom disappeared, 2 patients suffered from prosopo-eminence, 1 patient was asymptomatic and 1 patient was feeling better). Two patients underwent removal of crista galli, 1 of them suffered from postoperative cerebro-spinal
rhinorrhea, and recovered after endoscopic repairing procedure and
iodoform gauze packing and recovered 15 days later. Two patients who underwent removal of crista galli suffered from
anosmia and never recovered after 9 and 26 months follow-up. One patient with enormous
osteoma suffered from repeated crusting and abnormal odor, and recovered after nasal
flushing.
CONCLUSIONS: Endoscopic ablation of
osteomas of the ethmoid sinuses with the guidance of navigation system is an accurate, secure, minimally-invasive procedure.
Osteomas on median line and localized in ethmoid sinus is an indication of this operation. Preoperative CT scan is a safeguard for an accurate operation.