title: Update on management of frontal sinus osteomas.
abstract: OBJECTIVE
  Endoscopic approaches are used increasingly as an alternative to external approaches in removal of frontal sinus osteoma. The purpose of this article is to review and highlight the recent articles on the management of frontal sinus osteoma over the past 24 months.
  
  
  RESULTS
  The evolution in endoscopic sinus surgery has allowed rhinologists to expand its indications in managing a wide range of frontal sinus pathologies, including frontal sinus osteomas. The surgeons are attempting endoscopic removal of higher grades of osteomas from frontal sinus, previously thought to be amenable only to external approach on its own or combined with endoscopic approach. Although recent retrospective studies have reported such successful attempts, open approaches, particularly osteoplastic flap, remain an important surgical technique when endoscopic approaches are limited.
  
  
  CONCLUSIONS
  The endoscopic approach is effective in surgical management of low-grade osteomas. For higher-grade (grade III and IV) osteomas endoscopic removal is technically challenging and requires availability of advanced instrumentation, including surgical navigation systems, along with surgical expertise.Open approaches to frontal sinus, particularly osteoplastic flap approach, are still valuable as it is a simple and well tolerated method for complete removal of higher-grade osteomas.
authors.affiliation: Department of ENT, Royal Hampshire County Hospital, Winchester, Hampshire, UK. ashokrokade@hotmail.com
authors.forename: Ashok
authors.initials: A
authors.lastname: Rokade
authors.forename: Anshul
authors.initials: A
authors.lastname: Sama
mesh_terms: D001859:Bone Neoplasms / Q000175:diagnosis / Q000601:surgery*; D004724:Endoscopy; D005626:Frontal Sinus; D006801:Humans; D010016:Osteoma / Q000175:diagnosis / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D010255:Paranasal Sinus Neoplasms / Q000175:diagnosis / Q000601:surgery*