Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Safran, B.
Endoscopic treatment of paranasal sinus and skull base osteomas with particular attention to limitations, alternative access paths and recurrence rate – A retrospective explorative study.
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2017. pp. 55
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Tomazic Peter Valentin
- Wolf Axel
- Altmetrics:
- Abstract:
- Introduction: Osteomas are benign tumours of the paranasal sinuses of unknown etiology. Most osteomas are asymptomatic, slow-growing lesions diagnosed incidentally by radiologic imaging. Approximately 10% of all osteomas of the paranasal sinuses produce clinical symptoms. These tumours can be treated by an endoscopic, open or combined surgery. Material and Methods: In this retrospective study 59 surgically treated cases, treated at the University Hospital of Graz between 2001 and 2015, of osteomas of the paranasal sinuses and skull base were examined and analysed. Results: We included 32 males (54,2%) and 27 females (45,8%) with an age range of 13 – 75 years (mean age 42,08 years). The tumour localisation was divided as follows: 35 osteomas localized in the frontal sinuses (59,3%), 15 cases of osteomas of the ethmoidal cells (25,4%), 6 patients with osteomas in the maxillary sinuses (10,2%), 2 osteomas in the sphenoidal sinuses (3,4%) and one osteoma of the skull base (1,7%). Except one patient, who was treated because of the rapid tumour growing, all patients present symptoms, which were evaluated: 17 cases of pressure (28,8 %), 29 cases of pain including headache (49,2 %), 19 cases of nasal breathing obstruction (32,2 %) and 31 cases of recurring sinusitis (52,5 %). Most of the patients reported more than one symptom. The endoscopic technique was used in 30 cases, while the open surgery has been used on 11 patients and the combined surgical treatment was in 18 cases the method of choice. We also found two cases of recurrence and several cases of surgical complications: 3 cases of postoperative bleeding and one case of refractory cephalea and sinusitis after using the endoscopic technique, one case of CSF leak after an open surgery treatment and 4 cases of complications after a combined surgery including two cases of CSF leaks, one case of postoperative strabismus and one case of a drainage, which moved into a wrong position. Conclusion: In this study we showed that excellent results can be achieved with external, endoscopic and combined approaches if they are indicated carefully for each patient. Minimal invasive endoscopic approaches can lead to excellent results and should be preferred if total tumour resection can be achieved.