Surgical Management of the Most Common Benign Craniofacial Fibroosseous Lesions

Abstract

Background: fibro-osseous lesions of craniofacial bones are a challenging group of pathological conditions that are difficult to classify and treat. Unfortunately, there are no universally accepted clinical, radiological, or histopathological criteria that distinguish these lesions from one another. It is often quite challenge to establish their biologic behavior and treatment. Objective: To outline the the different surgical modalities for management of the most common symptomatic craniofacial fibro-osseous lesions and to evaluate the appropriate surgical management with follow up results. Patients and methods: Sixteen patients with biopsy confirmed craniofacial fibro-osseous lesions were enrolled in our study from Mars 2009 to Mars 2012 in otorhinolaryngology department zagazig university hospital. They were operated using endoscopic and open surgery. All patients were submitted in thorough history taking, clinical, radiological, and histopathological examinations, with a follow up period from six months to two years. Results: The most common cases were osteoma 10 cases (62.5%), the fibrous dysplasia was the second most common 6 case (37.5%). Ethmoid and frontal sinus were the most common sinuses involved with osteoma, the maxillary sinus was the most common sinus involved with fibrous dysplasia. There were 3 complications the first was CSF leak, the second was incomplete removal of fibrous dysplasia, and the third was diminution of vision in the epsilateral eye of the huge ethmoidal osteoma due to optic nerve oedema resolved by medical treatment. Conclusion: management of craniofacial fibro-osseous lesions is highly individualized and it is the task of the surgeon to tailor the surgical procedure according to the clinical and radiological data.