Osteomas of the paranasal sinuses are common, especially of the frontal sinus, and they can grow quite large and result in obstruction to normal mucociliary drainage. Erosion into the intracranial cavity with pneumocephalus and meningitis is distinctly uncommon.
The patient went on to have this mass excised and his anterior cranial fossa repaired. The diagnosis of osteoma was confirmed histologically.
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