title: Orbital osteoma: clinical features and management options.
abstract: OBJECTIVE
  This study reviews the clinical presentation and management of 11 cases of sino-orbital osteoma.
  
  
  METHODS
  The medical records of patients with primary (originating from orbital bone) and secondary (originating from the paranasal sinuses) orbital osteoma from the academic practices of 4 surgeons (A.V.C., M.J.L., P.J.D., V.D.D.) were reviewed for clinical presentation and course, pathologic study, and radiologic reports. A Medline search of English-language literature on orbital osteomas was conducted for comparison with these findings.
  
  
  RESULTS
  Eleven cases of primary (1) and secondary (10) orbital osteoma were reviewed, with a mean follow up of 16 months. Seven patients were women. Ages ranged from 15-68 years, with a median of 40 years. Presenting complaints included slowly progressive globe displacement, palpable bony nodule, pain, and diplopia. Surgery was performed in 10 cases. Surgical approach varied according to location and size of each lesion and was performed in combination with otolaryngology and neurosurgery services as needed. Reconstruction included sculpting osteomatous bone to natural orbital contours, repair of orbital wall defects with implants, and obliteration of frontal sinus. Lesions demonstrated mixed compact, cancellous, and fibrous histologic subtypes.
  
  
  CONCLUSIONS
  Osteomas are the most common tumor of the paranasal sinuses (noted in up to 3% of coronal CT images), but secondary extension in or primary involvement of the orbit is rare. A variety of surgical approaches led to successful outcomes in this series. Complete surgical removal is not always necessary, and partial sculpting may relieve symptoms and cause less surgical morbidity in selected cases.
authors.affiliation: *Department of Ophthalmology, Oculoplastic and Orbital Surgery Service, University of Colorado Denver, Denver, Colorado; †Department of Ophthalmology, Oculoplastic, Facial Cosmetic, and Orbital Surgery Service, University of Wisconsin-Madison, Madison, Wisconsin; ‡Department of Otolaryngology and Head and Neck Surgery, University of Colorado Denver, Denver, Colorado, U.S.A.; §Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; ‖Oculoplastics Division, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, U.S.A.; On leave of absence from the ¶Craniofacial Unit of the Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto-University of São Paulo, São Paulo, Brazil; and #Department of Ophthalmology, Oculoplastics, Lacrimal, and Orbital Surgery Service, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Wei
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Ramey
authors.forename: Vikram D
authors.initials: VD
authors.lastname: Durairaj
authors.forename: Vijay R
authors.initials: VR
authors.lastname: Ramakrishnan
authors.forename: Augusto V
authors.initials: AV
authors.lastname: Cruz
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Dolman
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Lucarelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D009918:Orbital Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery; D010016:Osteoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D010255:Paranasal Sinus Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies; D055815:Young Adult