Maxillary sinus osteoma: From incidental finding to surgical management
A 39-year-old man was referred by his general dental practitioner for an incidentally found round radio-opaque tumor in the left maxillary sinus on the orthopantomogram (OPG) []. The patient was asymptomatic, but very concerned about the nature of the tumor. Otherwise he was in good health, particularly he did not complain of any gastrointestinal or skin symptoms. The extra- and intraoral examinations were unremarkable. The dentition, especially in the upper left quadrant was unremarkable and vital on cold test. Computed tomography (CT) of the head and paranasal sinuses was performed, which revealed a solitary exophytic osseous tumor that was pedunculated and attached to the dorsolateral wall of the maxillary sinus []. We removed the tumor from the left maxillary sinus by “modified Caldwell–Luc” approach under general anesthesia [Figures and ]. The osseous tumor was visible after the bony window from the anterior wall of the maxillary sinus was lifted []. The stalk of the tumor was separated from the dorsal aspect of the sinus by a chisel and the tumor was mobilized. Because of its large size, it had to be divided inside the sinus cavity. The osseous tumor measuring 2.1 cm in diameter was finally removed in three parts []. The defect of the anterior wall was easily closed by suturing back the bony window of the maxillary sinus with absorbable sutures. The final histopathology report confirmed the diagnosis of the maxillary sinus osteoma with no signs of malignancy [Figures and ]. Our patient remained asymptomatic at his 3rd-month of follow-up.