Abstract Listings 2024

Purpose

This case report aims to present the diagnostic process and outline the planned treatment approach for a 24-year-old female patient diagnosed with a right-sided frontal ethmoid orbital ivory osteoma causing refractive changes due to the mass effect of the lesion.

Methods

On presentation, the visual acuities were 0.96 Log Mar with pinhole correction improving to 0.12 Log Mar in the right eye, and -0.10 Log Mar in the left eye. Clinical evaluation showed proptosis, hypoglobus, pain on up gaze and a possible palpable lesion in the medial orbital region. Subsequent MRI imaging confirmed the presence of an osteoma in the right frontal ethmoid region. The patient was then referred to a skull base surgeon for comprehensive evaluation and treatment planning. A multidisciplinary team comprising ophthalmologists and otolaryngologists collaborated to develop a tailored management strategy.

Results

At present, the patient has not undergone surgical intervention. However, a treatment plan has been formulated, involving combined endonasal and transorbital debulking/resection of the osteoma to alleviate symptoms and restore facial aesthetics. In the event of a cerebrospinal fluid (CSF) leak during the procedure, repair will be performed utilizing local tissue grafts harvested from the patient’s nasal mucosa or thigh region.

Conclusion

This case underscores diagnostic challenges and a multidisciplinary approach required in managing this uncommon benign orbital tumour originating from the anterior skull base. Paranasal sinus osteomas are slow growing benign tumours which are generally asymptomatic. Endoscopic approaches have been successful in appropriate cases since the advancement in technology and introduction of image guided surgery.

Additional Authors

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