Cholesteatoma of the frontal sinus.
OBJECTIVE
Cholesteatoma of the paranasal sinuses is a rare pathology. A review of the literature reported less than 30 cases. These lesions mainly involve the frontal sinus.


METHODS
A 25-year-old man presented with a right painful fronto-orbital mass associated with an ipsilateral eyelid oedema and a fever as high as 40°C. He experienced a general epileptic seizure requiring his admission in an intensive care unit. CT-Scan with iodine injection evidenced the opacification of the right frontal sinus with bone lysis of the posterior wall. Complete surgical resection of a cystic structure containing keratin material was performed via eyebrow incision. The pathological examination confirmed the diagnosis of sinus cholesteatoma. Neurological signs entirely disappeared after surgery. Craniofacial MRI realized 2 months later showed no sign of recurrence. Obliteration of the right frontal sinus was performed 4 months later.


CONCLUSIONS
Although benign, cholesteatoma can spread to the surrounding structures leading to several complications including infections that can be life-threatening for the patient. CT-scan and MRI are useful examinations for diagnosis and follow-up. Complete surgical resection is required in order to avoid recurrence.
Service d'ORL et chirurgie cervicofaciale, CHU Habib Bourguiba, 3029 Sfax, Tunisia.
B
B
Hammami
M
M
Mnejja
A
A
Chakroun
I
I
Achour
A
A
Chakroun
I
I
Charfeddine
A
A
Ghorbel
D000328:Adult; D002781:Cholesteatoma / Q000175:diagnosis / Q000601:surgery; D005626:Frontal Sinus; D006801:Humans; D008297:Male; D010255:Paranasal Sinus Neoplasms / Q000175:diagnosis / Q000601:surgery