Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1607066
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Removal of a Frontal Sinus Osteoma and Reconstruction by a Custom-Made Implant with Neuronavigation Assistance

Vincenzo Palazzolo
Department of Maxillofacial Surgery, Sant'Anna Hospital, San Fermo Della Battaglia, Como, Italy
,
Anita Tronchet
Department of Maxillofacial Surgery, Sant'Anna Hospital, San Fermo Della Battaglia, Como, Italy
,
Stefano Valsecchi
Department of Maxillofacial Surgery, Sant'Anna Hospital, San Fermo Della Battaglia, Como, Italy
,
Silvio Bellocchi
Department of Neurosurgery, Sant'Anna Hospital, San Fermo Della Battaglia, Como, Italy
,
Carlo Gervasoni
Department of Maxillofacial Surgery, Sant'Anna Hospital, San Fermo Della Battaglia, Como, Italy
,
Stefano Spotti
Department of Maxillofacial Surgery, Sant'Anna Hospital, San Fermo Della Battaglia, Como, Italy
,
Andrea Di Francesco
Department of Maxillofacial Surgery, Sant'Anna Hospital, San Fermo Della Battaglia, Como, Italy
,
Luigi Colombo
Department of Maxillofacial Surgery, Sant'Anna Hospital, San Fermo Della Battaglia, Como, Italy
,
Stefano Riccio
Department of Maxillofacial Surgery, Sant'Anna Hospital, San Fermo Della Battaglia, Como, Italy
,
Paolo Ronchi
Department of Maxillofacial Surgery, Sant'Anna Hospital, San Fermo Della Battaglia, Como, Italy
› Author Affiliations
Further Information

Publication History

11 January 2017

02 July 2017

Publication Date:
02 November 2017 (eFirst)

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.