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 ethmoid region osteomas is done if they extend beyond the boundaries of the ethmoid cells, keep enlarging, are localised in the region adjacent to the nasofrontal duct, or if signs of chronic sinusitis are present and, irrespective of their size, if patients with osteomas complain of headache. Preoperative computed tomography and/or magnetic resonance is necessary for planning the surgery. Surgical approaches are divided into external, endoscopic and combined endoscopic
and external procedures.
Case report: The purpose of the paper is to present a case of the ethmoid cells osteoma and to discuss the
performed surgical procedure used to remove it en bloc under endoscopic guidance. A 41-yearold woman presented with 20-month history of headaches in the orbital region. CT imaging disclosed an intense shadow 1.0 cm in diameter. The osteoma localised right below the frontal sinus ostium was visualised, dissected, mobilised and removed en bloc. Pathology confirmed an osteoma. The patient’s postoperative course was uneventful, she has been asymptomatic for
4 months.
Conclusions: Medium size ethmoid cells osteomas can be effectively approached by an endoscopic procedure.
Considering all risks of the method, resection of early stage tumours and adjacent chronically inflamed tissues can be in selected cases safely and radically performed using endoscopic techniques.

Keywords: Paranasal Sinuses, sinus surgery, Osteoma