Endoscopic sinus surgery for benign osteogenic tumors of nasal cavity and paranasal sinuses——A clinical analysis of 14 cases

Objective To explore the feasibility and surgical techniques of endoscopic sinus surgery for benign osteogenic tumors of nasal cavity and paranasal sinuses. Methods Clinical data of 14 patients with benign osteogenic tumors of nasal cavity and paranasal sinuses and receiving endoscopic sinus surgery from June 1998 to May 2012 in our department were analyzed retrospectively. Results Of all the 14 patients,6 were male and 8 were female,aged from 7 to 47 years with an average of 25. 1 years. The involved tumors included osteoblastoma( n = 1),osteoid osteoma( n = 1),ossifying fibroma( n = 7),fibrous dysplasia( n = 1),ethmoid osteoma( n = 1),frontal sinus osteoma( n = 1) and sphenoid sinus osteoma( n = 2). The main clinical symptoms were nasal congestion,headache,facial pain and progressive eye bulge. Preoperative sinus high-resolution CT( HRCT) examination was performed for all patients to analyze the tumor 's location and display the extent of the lesions. All surgical procedures were performed under general anesthesia. 11 patients underwent nasal endoscopic surgery and 3 patients received endoscopic surgery combined with other external approaches. Complete tumor resection was achieved in 9 cases,and partial resection in 5. All patients had been following up for an average duration of 67 months. Two cases with ossifying fibroma extenting to the orbit and anterior cranial fossa got recurred 2 months and 8 months postoperatively and underwent reoperation respectively. Of them,the lesion was controlled in one case and the other one underwent the third operation in other hospital. The osteoblastoma recurred 4 months postoperatively and the patient underwent reoperation,but still had residual tumor which extended to the crista galli of anterior cranial fossa, the patient underwent the third operation in other hospital 2 years postoperatively and then was lost to follow-up. All other patients had no recurrence, no serious complications occurred. Conclusion The surgical treatment of benign osteogenic tumors of nasal cavity and paranasal sinuses is sometimes very complex. The tumor can be completely removed by endoscopic sinus surgery when it is confined to the nasal cavity and paranasal sinus. When it extends to the cranial cavity and vital structures such as internal carotid artery or optic nerve,it is impossible to resect the lesion completely via endoscopic sinus surgery,and then multidisciplinary combined surgery or other adjuvant therapy should be considered.