Presentation
Headache and postnasal discharge screening for sinusitis.
Patient Data
Focal bone thickening with size up to 8mm in right side ethmoid sinus close to the midline is seen. Bilateral nasal concha bullosa and left-side nasal septum deviation with small spur are also seen.
Case Discussion
Ethmoid sinus osteoma can slowly and progressively enlarge and penetrates the base of the skull or obliterates the frontal sinus outflow tract with subsequent sinusitis. The frontal sinus is the most prevalent site for paranasal sinus osteoma in the first order, followed by the ethmoid sinus in the second order.
There are three types of osteoma; ivory, mature, or mixed. Ivory osteomas are uniformly dense, whereas mature osteomas may look like regular bone, with marrow space.
The main differential diagnosis, in this case, is ossifying fibroma, exostosis or bony spur, and non-pneumatized ethmoidal air cell.
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