title: Preservation of natural frontal sinus outflow in the management of frontal sinus osteomas.
abstract: BACKGROUND
  Management of frontal sinus tumors has traditionally been through open approaches with obliteration of the sinus. Recently, increased comfort with endoscopic techniques has made endoscopic resection an alternative to more morbid approaches. However, many skilled endoscopists still champion obliteration of the frontal sinus after the open treatment of large osteomas.
  
  
  METHODS
  A retrospective review of the senior author's experience with frontal sinus osteomas was performed.
  
  
  RESULTS
  Twelve frontal sinus osteomas were treated surgically without obliteration. All patients with greater than 2 cm vertical extension of their tumor into the frontal sinus required an open approach (n = 4), whereas the remainder (n = 8) were treated endoscopically. Frontal ostia were stented if greater that 40% of the mucosa of the frontal recess was denuded. Eleven of 12 patients had patent, functional frontal sinuses.
  
  
  CONCLUSIONS
  Successful resection of frontal sinus osteomas can be performed with preservation of the natural drainage of the frontal sinus in almost all cases.
  
  
  METHODS
  C-4.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Johns Hopkins University, 601 North Caroline Street, Baltimore, MD 21287-0910, USA. mdubin2@jhmi.edu
authors.forename: Marc G
authors.initials: MG
authors.lastname: Dubin
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Kuhn
mesh_terms: D000328:Adult; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D005626:Frontal Sinus / Q000601:surgery*; D006801:Humans; D008297:Male; D010016:Osteoma / Q000473:pathology* / Q000601:surgery*; D010255:Paranasal Sinus Neoplasms / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome