Title : Surgical treatment of paranasal sinus osteomas: Need for a new grading system
Paranasal sinus osteomas are slow-growing osseous tumors, representing the most common benign neoplasm of the nose and paranasal sinuses. They usually involve the frontal sinus, followed by the ethmoid labyrinth. Histologically, they are composed of mature, hyperplastic osseous tissue and can be classified into three types: ivory, mature, and mixed. They usually exhibit a slow growth rate, and many will remain lifelong asymptomatic. Occasionally, they can grow significantly and expand destructively beyond the confines of the sinonasal tract, causing severe and sometimes even life-threatening sequelae. Surgical excision represents the unequivocal treatment modality for symptomatic paranasal sinus osteomas. However, the optimal surgical approach and the extent of the surgery remain controversial.
This keynote presentation will explore recent advances in the management of symptomatic and asymptomatic paranasal sinus osteomas, focusing on the recent shifts in trends of their surgical treatment. Over the past 30 years, endoscopic techniques have emerged as the new standard of care for favorably located paranasal sinus osteomas. Our most recent experience with managing some cases of giant tumors, which are far more technically demanding, will also be presented. Based on our past decade experience, a new grading system for frontal and frontoethmoidal osteomas is proposed to better conform to recent advancements and current clinical, research, and educational needs.