Frontal sinus osteoma.

Osteoma is the most common benign tumor of the nose and paranasal sinuses, and the frontal sinus is its most frequent location. This tumor may be discovered incidentally on radiographs or may enlarge to produce symptoms and, rarely, complications referable to its location near the orbit and anterior cranial vault. A series of 22 cases of frontal sinus osteoma treated at the UCLA Center for the Health Sciences is reviewed. The presenting symptoms of this tumor, patient examination, radiographic evaluation, diagnosis, and indications for surgical and nonsurgical management are discussed. Various surgical approaches are reviewed, with emphasis on the advantages and disadvantages of each technique. Issues at surgery include the location of the surgical incision, technique of sinus entry, tumor removal, status of the posterior sinus table, patency of the nasofrontal duct, sinus obliteration, and avoidance of cosmetic deformity. Patient outcomes are assessed and recommendations given based on our findings and experience.