Removal of a Frontal Sinus Osteoma and Reconstruction by a Custom-Made Implant with Neuronavigation Assistance. Issue 4 (December 2018)

• Record Type: Journal Article
• Authors: Palazzolo, Vincenzo; Tronchet, Anita; Valsecchi, Stefano; Bellocchi, Silvio; Gervasoni, Carlo; Spotti, Stefano; Francesco, Andrea Di; Colombo, Luigi; Riccio, Stefano; Ronchi, Paolo
• Is Part Of: Craniomaxillofacial trauma & reconstruction. Volume 11:Issue 4(2018)
• Page Start: 305
• Page End: 313
• Publication Date: 2018-12
• Subjects: frontal sinus osteoma -- hydroxyapatite custom-made implant -- neuronavigation assistance; Face -- Wounds and injuries -- Periodicals; Face -- Surgery -- Periodicals; Maxilla -- Wounds and injuries -- Periodicals; Maxilla -- Surgery -- Periodicals; Face -- Surgery; Face -- Wounds and injuries; Maxilla -- Surgery; Maxilla -- Wounds and injuries; Maxillofacial Injuries -- Periodicals; Craniocerebral Trauma -- Periodicals; Reconstructive Surgical Procedures -- methods -- Periodicals; Fulltext; Internet Resources; Periodicals; Periodicals; 617.522
• DOI: 10.1055/s-0037-1607066
• Languages: English
• ISSNs: 1943-3875

Abstract

The authors report the surgical treatment of an extensive right frontal sinus osteoma assisted by neuronavigation and reconstruction by a hydroxyapatite custom-made implant. The patient presents with ptosis, hypoglobus, and proptosis of the right eye, without any visual impairment. Computed tomographic (CT) scan showed a very large bony mass involving right frontal sinus and displacing the orbital roof. A stereolithographic model–guided planning was carried out to obtain a practical simulation of the surgical operation and it was submitted to a new CT scan to acquire the reference point to realize the neuronavigation assistance, and to achieve the template to realize the hydroxyapatite custom-made implant. Intraoperatively, with the help of neuronavigation assistance, osteotomies were performed by piezoelectric device. The reconstruction was made using a hydroxyapatite custom-made implant. The procedure was damage free, the bony mass was excised, and the orbital roof was repaired without any adverse effects. Postsurgical CT scan and scintigraphy showed a good reconstruction and a good-quality osteoblasts activity on the borders of the implant. Osteoma is a benign slow-growing bone tumor, usually involving the frontal sinus. Navigational assistance offers a very important help to perform safe osteotomies. Hydroxyapatite custom-made implant seems to be an excellent reconstructive method.