Endoscopic modified lothrop procedure: an alternative for frontal osteoma excision.

PURPOSE To describe three cases of frontal osteoma which were safely removed with a stereotactic-assisted, endoscopic modified Lothrop approach (EMLP). METHOD Retrospective case review. RESULTS Three patients presented with extensive frontal sinus osteomas. Two underwent an EMLP and one patient with osteoma extending significantly into the orbit had an EMLP for removal of the medial frontal sinus component combined with an anterior orbitotomy to remove the orbital extension. In all cases stereotactic localization was utilized to ensure preservation of the skull base. Post-operatively, one patient required debridement of oedema at the junction of a lateral mucocele and the frontal sinus. The other two patients remained well post-operatively with no complications. At follow-up, there was no tumour recurrence. CONCLUSION A stereotactic-assisted, EMLP with or without an orbital approach may be considered for the removal of large frontal osteomas and may provide a less invasive alternative to traditional external approaches.

[1]  J. O'Connell,et al.  Primary bone tumors of the orbit. , 2004, Survey of ophthalmology.

[2]  R. Schlosser,et al.  The Modified Lothrop Procedure: Lessons Learned , 2001, The Laryngoscope.

[3]  B. Schick,et al.  The role of endonasal surgery in the management of frontoethmoidal osteomas. , 2001, Rhinology.

[4]  C. Ohye.  The Idea of Stereotaxy toward Minimally Invasive Neurosurgery , 2001, Stereotactic and Functional Neurosurgery.

[5]  P J Kelly,et al.  Stereotactic surgery: what is past is prologue. , 2000, Neurosurgery.

[6]  M. Desrosiers,et al.  Bifrontal Endoscopic Resection of Frontal Sinus Osteoma , 1998, The Laryngoscope.

[7]  N. Hopf,et al.  Basic principles and clinical applications of neuronavigation and intraoperative computed tomography. , 1998, Computer aided surgery : official journal of the International Society for Computer Aided Surgery.

[8]  S. C. Chang,et al.  Treatment of Frontal Sinus Osteoma Using a Craniofacial Approach , 1997, Annals of plastic surgery.

[9]  C. Gross,et al.  Modified Transnasal Endoscopic Lothrop Procedure as an Alternative to Frontal Sinus Obliteration , 1995, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[10]  A. Seiden,et al.  Endoscopie Trephination for the Removal of Frontal Sinus Osteoma , 1995, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.