Solitary osteoma in the zygomatic arch.

To the Editor: Osteoma is a common benign neoplasm characterized by the proliferation of compact or cancellous bone, and one of the most common tumors of the nose and paranasal sinuses. Anatomically, it can be peripheral, central, or extraskeletal, and the growth behavior is dependent on the activity of the periosteum or endosteum. In a recent series of 116 patients with craniofacial osteomas, only 10 cases involved the middle third of the face. To date, only 2 reports of solitary osteoma arising in the zygomatic arch have been described in the international literature. Here, the authors describe a patient with zygomatic arch osteoma and emphasize the surgical approach. The case was a 32-year-old black woman with a 6-year history of a slow-growing painful swelling in the right side of the face. The patient reported associated headache and chronic facial pain related to the right masticatory muscles. The onset was spontaneous and there was no history of trauma. Clinical examination revealed a firm bony hard swelling above the right zygomatic arch, approximately 3 cm in diameter (Fig. 1A). CT scan showed a well-defined, very dense tissue image mainly composed of a homogeneous mass on the right zygomatic arch (Fig. 1B). The approach to the zygomatic arch was performed by means of an extended preauricular incision. After incision of the superficial temporal fascia over the zygomatic arch, a complete view of the lesion was obtained (Fig. 1C). With the use of periosteal elevators, the lesion was easily excised. After osteotomy and tumor removal, rigid internal fixation with 2.0 titanium plate was used to restore the normal bone architecture (Fig. 1D). A masseter

[1]  Marcia Provenzano,et al.  Osteoma of the zygomatic arch and mandible: Report of two cases , 2012 .

[2]  K. Nah Osteomas of the craniofacial region , 2011, Imaging science in dentistry.

[3]  G. Iannetti,et al.  Osteomas of the Maxillofacial District: Endoscopic Surgery Versus Open Surgery , 2008, The Journal of craniofacial surgery.

[4]  E. Valmaseda-Castellón,et al.  Osteomas of the craniofacial region. Review of 106 cases. , 2007, Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology.

[5]  L. Guarda-Nardini,et al.  The bicoronal approach for the treatment of a large frontal sinus osteoma. A technical note. , 2007, American journal of otolaryngology.

[6]  C. Heitz,et al.  Osteoma of the zygomatic arch--report of a case. , 2004, International journal of oral and maxillofacial surgery.

[7]  Coro Bescós-Atín Osteomas de los senos paranasales , 1990 .