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Osteomas are slow-growing benign osseous tumors that particularly located in the paranasal sinuses (PS). Here, we aimed to define the clinical symptoms and features, diagnostic conditions caused by osteomas located in four different PSs, to evaluate the surgical indications and methods, to compare the factors that can affect the surgical decision, radiological findings, and prognosis.The data of patients with paranasal sinus lesions and diagnosed as osteoma according to the radiological imaging, who applied to our clinic between 2010 and 2020, were retrospectively collected and re-evaluated in the light of clinical, radiological, and pathological data. Patients who underwent surgical treatments and were definitively diagnosed as osteoma by pathology were enrolled in this study.We presented the data of 117 patients retrospectively. Most of these cases (n = 77, 65.8%) had an osteoma located in the frontal sinus, while 32 cases (27.4%) had osteoma in the ethmoid, two cases (1.7%) had in sphenoid and six cases (5.1%) had in maxillary sinus. We found that the presence of symptoms, diameter of osteoma, surgical indications including state of sinus drainage, and chronic/recurrent sinusitis influence the choices of physicians in management of frontal sinus osteomas. Moreover, we found a significant correlation between the grading systems defined to classify the frontal sinus osteoma to be operated (r = 0.878, 95% CI: 0.724-0.949, P0.0001).There are several grading systems useful for the choice of surgical approaches, however, the clinical symptoms and surgical indications should not be neglected in the follow-up of patients with frontal sinus osteoma. If there are concerns about the grade of osteoma and the endoscopic approach is considered not to be sufficient for resection, the surgical procedure may be initiated endoscopically, and, if necessary, it can be combined with an external approach.

Purpose The frontal recess (FR) has a complex anatomy composed of a number of cells that dictate the frontal sinus drainage pathway. The International Frontal Sinus Anatomy Classification (IFAC) is a new system for classifying FR cells. This study investigated the prevalence and symmetry of IFAC cells in healthy sinuses and assessed the interrater agreement of IFAC cells. Methods 509 adult patients with non-diseased paranasal sinuses were included in this retrospective cross-sectional study. Two rhinologists independently identified IFAC cells on 1018 sides using triplanar CT reconstructions. The prevalence of each cell type was assessed, and interobserver agreement was measured using the kappa coefficient (κ). Results The prevalence of FR cells varied, with the agger nasi cell (ANC) being the most prevalent at 88.0% and the supra bulla frontal cell (SBFC) being the least prevalent at 7.1%. FR cells that pneumatize into the frontal sinus were identified in 28.6% of the FRs, with male patients having a significantly higher prevalence than female patients. The ANC had the highest bilateral incidence at 80.4%, while the SBFC had the lowest at 2.2%. All IFAC cells had excellent interrater agreement, with κ values ranging from 0.94 to 1.0. Conclusion The prevalence of FR cells varies among populations. Male patients were more likely to have FR cells that pneumatize across the frontal sinus. These results highlight the importance of considering population- and gender- specific prevalence rates of individual FR cells in endoscopic sinus surgery planning. IFAC is a reliable tool for identifying cells in the FR with a high level of interrater agreement.

Background/Aim: Closure of anterior tympanic membrane perforation is surgically demanding with high rates of graft failure. The anterior tab flap (ATF) technique is a modification of underlay tympanoplasty which claims higher success rates for repairing anterior and subtotal perforations. Our main aim was to compare graft take rates of ATF and underlay techniques in anterior tympanic membrane perforations.Method: In this retrospective cohort study, 41 patients with anterior tympanic membrane perforations who underwent tympanoplasty at a tertiary referral center were analyzed. The patients were grouped according to the technique used. Demographic, clinical, and follow-up information as well as preoperative and postoperative 6th-month audiometric data were collected and compared between the groups. Results: Four patients were lost to follow-up. Eighteen patients in the ATF arm and 19 patients in the underlay arm were compared. Graft take rates were 94.4% in the ATF group and 73.7% in the underlay group (P=0.180). An air conduction threshold average of 0.05). The postoperative ABG of the ATF and underlay group patients were less than 20 dB in 76.5% and 78.9%, respectively (P>0.05). No graft lateralization, anterior blunting, or cholesteatoma were observed.Conclusion: ATF is a safe and effective technique with a higher success rate for repairing anterior tympanic membrane perforation.

Background/Aim: Surgery for tympanosclerosis with stapes fixation for hearing reconstruction is controversial, with many reports in the relevant literature advocate opposing suggestions. The primary aims were to evaluate hearing improvement with varied hearing reconstruction techniques performed for tympanosclerosis with stapes fixation. Methods: Patients with tympanosclerosis and stapes fixation, whose hearing impairment was re-constructed surgically and who were followed for 1-5 years were reviewed in this retrospective cohort study. The audiological outcomes of reconstruction methods, including mobilization, partial ossicular replacement prosthesis (PORP), total ossicular replacement prosthesis (TORP), and teflon pistons (TP) were documented.Results: The study included 76 ears of 76 patients; 29 ears in the mobilization technique group, 28 ears in the PORP technique group, 10 ears in the TORP technique group, and 9 ears in the TP technique group. When postoperative and preoperative hearing were evaluated, the mobilization and PORP techniques showed statistically significant improvement in both air conduction threshold gain and air-bone gap closure (P0.05). Bone conduction threshold showed no significant deterioration in any techniques. Conclusion: For hearing gain, mobilization and PORP were effective in tympanosclerosis patients with stapes fixation after removal of sclerotic plaques, whereas the TORP and TP techniques did not show significant improvement. It can be concluded that, if a functionally mobile stapes cannot be achieved, it is not advisable to perform TORP replacement or a stapedotomy. However, these methods may still be used in carefully selected patients and be successful in some.

Middle turbinate osteoma is very rare and only two times have been reported before. We reported a 31-year old male presenting middle turbinate osteoma that extending into the anterior cranial fossa, causing pneumocephalus. The osteoma was resected by combining endoscopic sinus surgery with bifrontal craniotomy and the patient was relieved of headaches.