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Published on: August 16, 2024
Frontal Sinus Osteoma Presenting with Meningitis and Epilepsy
John Paul G Kolcun1, Angela M Richardson1, Joanna E Gernsback1
1Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
Background:
Osteomas are benign lesions of bone, most frequently seen in the paranasal sinuses; however, they are typically asymptomatic and without complication. We report a rare case of large frontal sinus osteoma with intracranial extension, associated with meningitis and the development of seizures.
Case Description:
The patient is a 38-year-old man with a prolonged history of headache and seizures, who was seen by multiple specialists previously, all of whom deferred treatment. After years of worsening seizure activity, he finally underwent surgical resection of the lesion at our institution in a joint operation with neurosurgery and otolaryngology. We examine his course, presentation, and management, and examine the literature for cases of complicated sinus osteomas.
Conclusions:
This represents the fourth reported case of frontal sinus osteoma associated with meningitis. We believe this case demonstrates the value of a robust differential and a multidisciplinary approach.
Insights
A rare large frontal sinus osteoma caused meningitis and seizures in a patient. Surgical resection was successful, highlighting the need for multidisciplinary care in complex cases.
Area of Science:
- Neurosurgery
- Otolaryngology
- Neurology
Background:
- Osteomas are benign bone tumors, commonly found in paranasal sinuses.
- Typically asymptomatic, large osteomas can lead to serious complications.
Observation:
- A 38-year-old man presented with chronic headache and worsening seizures.
- A large frontal sinus osteoma with intracranial extension was diagnosed.
- The patient had a history of meningitis.
Findings:
- This is the fourth reported case of frontal sinus osteoma associated with meningitis.
- Surgical resection of the osteoma was performed by a joint neurosurgery and otolaryngology team.
- The patient's seizures and headache resolved post-surgery.
Implications:
- Large or complicated sinus osteomas require a multidisciplinary approach for effective management.
- Early diagnosis and intervention are crucial for preventing severe neurological complications.
- This case underscores the importance of considering rare differentials in patients with refractory neurological symptoms.
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