Clinical Presentations and Surgical Management of Paranasal Sinus Osteomas: 15-Year Single-Center Experience

The aim of this study was to retrospectively review patients diagnosed with paranasal sinus osteoma and to present our clinical experience, focusing on the role, applicability, and outcomes of current surgical approaches in the management of these lesions. Patients with paranasal sinus osteomas who underwent surgical treatment (endoscopic, external, or combined approaches) at a tertiary referral center between January 2010 and January 2025 were retrospectively evaluated. A total of 43 patients were enrolled in the study. Demographic data, preoperative and postoperative records, paranasal sinus computed tomography scans, surgical notes, and histopathology results were analyzed. The study consisted of 43 patients (21 men, 22 women) with a mean age of 45.6 (range: 23-72). Osteomas were located in the frontal sinus (n=14), frontoethmoid region (n=8), ethmoid sinuses (n=19), and maxillary sinus (n=2). The most frequently observed complaint was headache (65.1%), followed by nasal obstruction (37.1%). The mean size of the osteomas was 16.4 mm (range: 4-60 mm). Endoscopic surgery was performed in 31 patients (72.1%), external surgery in 6 patients, and a combined approach in 6 patients; all external approaches were utilized in frontal sinus osteomas. Advances in endoscopic surgical techniques and instrumentation have established endoscopic surgery as the primary treatment modality for paranasal sinus osteomas. External or combined approaches should be reserved for selected cases in which complete endoscopic resection is not feasible due to the size, location, or extent of the lesion.