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Related Experiment Videos

Radionuclide bone scan in frontal sinus osteoma.

A M Noyek1, J S Chapnik, J C Kirsh

  • 1Department of Otolaryngology, Mount Sinai Hospital, Toronto, Ontario, Canada.

The Australian and New Zealand Journal of Surgery
|February 1, 1989
PubMed
Summary

Frontal sinus osteomas, often benign growths, may not require surgery if they aren't causing complications. Radionuclide bone scans help determine if an osteoma is active, guiding expectant management for non-problematic cases.

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Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Radiology

Background:

  • Frontal sinus osteomas are benign growths, potentially metaplastic, found near the frontal-ethmoid suture.
  • They can occur within the frontal sinus or ethmoid complex, at the embryologic junction of frontal bone types.
  • Surgical intervention is indicated for osteomas causing mechanical complications like ostial obstruction, facial deformity, or proptosis.

Purpose of the Study:

  • To review the outcomes of expectant management for 10 frontal sinus osteomas over 11 years.
  • To evaluate the utility of serial imaging and radionuclide bone scans in managing these lesions.
  • To differentiate between active and inactive osteomas to guide treatment decisions.

Main Methods:

  • Serial imaging including conventional X-rays and computerized tomography scans.

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  • Radionuclide bone scan performed at initial presentation for all patients.
  • Expectant management for patients with non-complicated osteomas and 'cold' bone scans.

    • Main Results:

    • Three out of ten osteomas with clinical complications or 'hot' bone scans were surgically removed via osteoplastic frontal sinusectomy.
    • Seven osteomas with 'cold' bone scans were managed expectantly over 4-11 years with validated outcomes.
    • A 'cold' bone scan indicated a biologically inactive osteoma, supporting non-operative management.

    Conclusions:

    • Expectant management is a validated approach for non-complicated frontal sinus osteomas, particularly those with 'cold' bone scans.
    • Radionuclide bone scan is a valuable tool for assessing osteoma activity and guiding management decisions.
    • Distinguishing between active and inactive osteomas can prevent unnecessary surgical intervention.