What are Osteomas?

Osteoma of the frontal sinus

Osteomas are the most common benign bony growth within the nasal passages and the sinuses. An osteoma is the focus of very dense bony deposit that might form within the paranasal sinuses. At the present time we do not know what causes osteomas to form, and what regulates their growth rate.

Most osteomas of the paranasal sinuses are benign in presentation, and do not need any special care. Osteomas are typically found during workup for recurrent sinusitis or any x-rays done to investigate nasal trauma. They are typically seen as a round bony overgrowth attached to a side wall of one of the sinuses. The most common location for them is the fronto-ethmoid recess of the paranasal sinuses, which is the region between the forehead and the area between the eyes. Most osteomas at the time of presentation may not have any significant clinical relevance. In select patients, the osteoma has grown to a certain size, and is now exerting pressure or blockage of the sinuses. This can then secondarily lead to sinus infections, accumulation of mucus, or excessive headaches.

If an osteoma has become problematic for the patient, the treatment is usually surgical. Using endoscopic techniques, many osteomas can be extracted through the nasal passages. Osteomas that are of certain size and are confined within the frontal sinuses (behind the forehead) may be too large to be extracted in this manner. Those patients may then need to have surgical excision through an incision in the scalp or around the eyebrows to access the sinus.

Alternatively, many osteomas are of curious observation relevance only. They could be observed over time, and only be removed if they appear to grow in size or start giving the patient complications associated with this location.

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