Endoscopic Transoral Resection of Parapharyngeal Osteoma: A Case Report

Osteoma is a benign, mesenchymal, slow-growing, osteogenic tumor commonly occurring in the craniofacial bones and is characterized by the proliferation of compact or cancellous bone. Solitary osteomas can be classified as peripheral (parosteal, periosteal, or exophytic) when arising from the periosteum or central (endosteal) when arising from soft tissue. Peripheral osteoma occurs most frequently in the paranasal sinuses. Other locations include the orbital wall, temporal bone, pterygoid processes, external ear canal, and, rarely, the mandible. Osteomas in the oromandibular region often appear in the jaw in the canine fossa, hard palate, and maxillary sinus and in the lower jaw in the inner mandible and outer circumference and lingual side of the molar region. At radiologic imaging, a peripheral osteoma of the mandible appears as a well-circumscribed, round to oval, mushroom-like radiopaque mass with distinct borders. Computed tomography is the best imaging modality for determining the location and actual extension of the lesion. Parapharyngeal space tumors are rare tumors of the head and neck region. Benign tumors of the parapharyngeal space are more common than malignant tumors. A foreign body sensation in the pharynx, difficulty with deglutition, and hoarseness are symptoms generally related to the position of the tumor. Upper airway obstruction, painful throat, unilateral tinnitus, trismus, dysarthria, glossopharyngeal neuralgia, and cranial nerve palsies are other reported symptoms. This report presents the case of a huge osteoma of the left mandibular condyle extending to the parapharyngeal space.