Summary
Background: Osteomas are relatively common, benign, slow-growing, often asymptomatic neoplasms of the paranasal sinuses, occurring mainly in frontal and ethmoid sinuses. Surgical removal of the frontal sinus osteomas is done in large tumours and in patients with frontal headache, vague changes in personality and neurological deficits being the most common symptoms. Giant frontal osteomas
are very rare. Preoperative computed tomography and/or magnetic resonance is necessary for planning the surgery. Surgical approaches are divided into external, endoscopic drill-out and combined endoscopic and external procedures.
Case Report: The purpose of the paper is to present a rare case of a giant frontal osteoma and to discuss a combined surgical procedure used to remove it due to the size and location of the tumour.
A 39-year-old woman presented with 12-month history of headaches in the frontal region. CT imaging disclosed an intense shadow 4.1 cm in diameter. Left coronal incision was performed
and the tumour was approached using external osteoplastic approach. The osteoma was split into parts and removed. Left endoscopic ethmoidectomy was performed in order to ensure proper drainage of the frontal sinus. No sinus obliteration was performed. Pathology con-
firmed an osteoma. The patient’s postoperative course was uneventful, she has been asymptomatic for 5 months.
Conclusions: Giant frontal osteomas can be effectively removed by combined external and endoscopic procedure. Obliteration of the sinus is not mandatory if the mucous membrane is normal.

Keywords: Osteoma, Paranasal Sinuses, sinus surgery