Transcoronal removal of an atypical orbitoethmoid osteoma

Craniofacial osteomas are lesions of bone that most commonly occur in the paranasal sinuses. Characteristically they remain dormant or slowly enlarge but remain asymptomatic. The more rapidly expanding tumor types may extend to adjacent structures, but signs and symptoms of such involvement are rare before the third decade. Presented is a patient with an ethmoid osteoma associated with a 2-year history of progressive proptosis first noticed at age 14. The operative approach afforded through a transcoronal incision combines excellent surgical exposure with hidden scar.