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CHAPTER 17
TUMOURS OF THE SINUSES

BENIGN TUMOURS

Osteoma. Osteoma of the frontal sinus is probably the most common benign
tumour arising in the nasal sinuses, and it is often discovered accidentally on
routine sinus radiography, possibly during the search for some other condi-
tion. The osteoma arises from the floor of the frontal sinus near the midline
(Fig. 42). In many instances there are no symptoms unless the osteoma
enlarges to block the entrance to the nasofrontal duct, or unless the sinus
becomes infected when headache is experienced. The chance discovery of an
osteoma calls for no treatment, and there should be no necessity to make the
patient aware of its presence. Removal of the osteoma by an osteoplastic flap
approach should be undertaken in the presence of symptoms due to a blocked
nasofrontal duct. The results are satisfactory.

Fig, 42. Osteoma of the right frontal sinus.

Fig. 43. Section of papillomatosis of the nose.

Papilloma. A diffuse form of papillomatosis may be found in the nasal cavity
and in the maxillary and ethmoidal sinuses. The papillomatous mass spreads
by expanding the walls of the sinus rather than by invasion, and it may be
difficult to determine the exact site of origin. The tumour is histologically
benign (Fig. 43), and it neither spreads to lymph nodes nor does it metastasize.
On the other hand, it tends to recur rapidly after removal. Nasal obstruction

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