Frontal sinus osteomas: the window of endonasal endoscopic approach.

Objective: Management of symptomatic osteomas involving the frontal sinus is challenging. Traditional external approaches have been used in the surgical management of these lesions. Recently, endonasal endoscopic surgery has become a valid alternative to the traditional external approach in selected cases.
Method of Study: Retrospective evaluation of the patients with symptomatic fronto-ethmoidal osteomas surgically managed in the last 10 years at a tertiary care facility.
Results: Twenty-six osteomas involving the frontal sinus were treated surgically. In 11 cases a purely endoscopic approach was performed while in 13 patients a combined procedure was used. In two patients, an exclusively external procedure was performed. No osteoma recurrence has been observed yet (mean follow up: 40 +/- 31.75 SD months).
Conclusions: Endonasal endoscopic resection of a frontal sinus osteoma is feasible when the lesion is medial to a virtual plane through the lamina papyracea and is attached in the lower portion of the posterior wall of the frontal sinus.