Endoscopic removal of a giant ethmoid osteoma with orbital extension

Osteomas are slow growing bony tumours of the paranasal sinuses. They are usually asymptomatic but they may present with headache, cerebral symptoms, or visual disturbances, depending on their anotomical location. A computerized tomography scan is the imaging modality that should be choosen for the diagnosis of osteomas. Radiographically, osteoid osteoma appears as an opaque lesion with a nidus which has a radioluscent center surrounded by dense sclerosis. If treatment is indicated, external or endoscopic approaches can be chosen. We report a rare case of giant ethmoido-orbital osteoma which was treated via endoscopic approach. The endoscopic way is convenient and safe enough with advantages over the external approach. The decreased morbidity and better cosmetic results are clear advantages of this technique which has the potential to become the treatment of choice for selected ethmoid tumours, such as a giant tumour mentioned in this study.