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Updated: Jun 24, 2026
09:53
Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
Frontal sinus osteoma presenting with orbital emphysema.
Loren S Jack1, Timothy L Smith, John D Ng
1School of Medicine, Oregon Health and Science UniversityPortland, Oregon, USA.
Ophthalmic Plastic and Reconstructive Surgery
|March 21, 2009
Summary
A frontal sinus osteoma, a benign tumor, can cause orbital emphysema. Surgical removal resolved recurrent eye swelling in a teen after nose blowing, preventing further air entry into the orbit.
Area of Science:
- Otolaryngology
- Neurosurgery
- Ophthalmology
Background:
- Osteomas are common benign neoplasms of the paranasal sinuses, frequently affecting the frontal sinus.
- While benign, frontal sinus osteomas can lead to severe intracranial or orbital complications.
- Orbital emphysema is a rare complication, characterized by air in the orbital tissues.
Observation:
- A 16-year-old boy presented with recurrent right-eye swelling following nose blowing.
- CT imaging revealed a bony mass in the right frontal sinus.
- Intraoperative findings showed mucosal strands connecting the frontal sinus to the orbit around the mass.
Findings:
- Histopathology confirmed the mass as an osteoma.
- The osteoma acted as a conduit, allowing sinus air to enter the orbit.
- This facilitated recurrent orbital emphysema, particularly after forceful exhalation like nose blowing.
Implications:
- Surgical excision of the frontal sinus osteoma and orbital roof repair were successfully performed.
- The procedure effectively resolved the recurrent orbital emphysema.
- This case highlights the importance of considering osteomas in the differential diagnosis of orbital complications secondary to sinonasal pathology.
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