Bicoronal approach in managing frontal sinus osteoma – case report
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Department of Otholaryngology, Municipal Hospital in Olsztyn, Poland
Department of Otholaryngology and Head and Neck Disease, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland
Clinic of Otholaryngology and Head and Neck Disease, Clinical University Hospital in Olsztyn, Poland
Submission date: 2016-10-18
Acceptance date: 2017-09-13
Online publication date: 2018-02-12
Publication date: 2019-11-17
Corresponding author
Natalia Jarmołowicz   

Clinic of Otholaryngology and Head and Neck Disease, School of Medicine, Collegium Medicum, Warszawska 30, 10-082 Olsztyn, Poland. Phone: +48 607 537 707.
Pol. Ann. Med. 2018;25(1):117-120
Giant osteomas of paranasal sinuses occur rarely, therefore there is no clearly stated surgical management, with varied approaches being reported in literature.

The aim of this study is to present the bicoronal approach as a treatment option for giant osteoma of the frontal sinus.

Case study:
This paper presents the case of 61-year-old female patient who was admitted to the hospital with a giant osteoma of the left frontal sinus. The patient was complaining of recurrent headaches, most often in the frontal region. The computed tomography showed a giant osteoma of left frontal sinus (36 × 30 × 24 mm). Due to the osteoma’s size and limitations of the intranasal technique, an external surgical approach was chosen. The tumor was resected from bicoronal incision, which enabled full visualization of the tumor and minimized the complication risk.

Results and discussion:
Giant osteomas of the frontal sinus frequently spread intracranially or into the orbit, which may lead to serious complications. The only course of action is surgery, and although endoscopic methods play a leading role today, giant osteomas often require external incisions. In the presented case, we describe the bicoronal approach as favorable for the surgeon as well as for the patient.

The advantage of the bicoronal approach as one of the surgical methods used to treat giant osteoma of the frontal sinus is to provide good access to pathologies within the frontal sinus that are impossible to remove endoscopically, together with a satisfactory aesthetic result.

None declared.
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