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Frontoethmoidal Osteoma with Secondary Intradural Mucocele Extension Causing Frontal Lobe Syndrome and Pneumocephalus: Case Report and Review of Literature.
World Neurosurg. 2018 Jul; 115:301-308.WN

Abstract

BACKGROUND

Paranasal sinus osteoma is a common, asymptomatic, histologically benign, slow-growing tumor. However, it can give rise to secondary pathologies such as a mucocele in about 50% of the cases. Rarely, intracranial and orbital extension is present, leading to rhinoliquorrhea, pneumocephalus, or neurologic and visual impairment, which might be potentially life-threatening.

CASE DESCRIPTION

A 49-year-old man presented with an acute frontal lobe syndrome and rhinoliquorrhea. Cranial magnetic resonance tomography showed a suspected frontoethmoidal osteoma with a mucocele expanding intradurally into the left frontal lobe. It was accompanied by pneumocephalus and showed communication with the left lateral ventricle. Through a bifrontal craniotomy, in toto resection of the frontoethmoidal bony tumor and the intradural mucocele was performed, while thereafter the frontal sinus was cranialized using a pedunculated periosteal flap. Postoperative recovery was uneventful with complete resolution of the tension pneumocephalus and rhinoliquorrhea and led to an improvement of the frontal lobe syndrome.

CONCLUSIONS

We present a rare case of pneumocephalus caused by a frontoethmoidal osteoma associated with an intradural mucocele. A review of the literature, focusing on the surgical strategies in such cases, is provided.

Authors+Show Affiliations

Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland.Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland.Department of Neuropathology, University Hospital of Basel, Basel, Switzerland.Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland.Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland. Electronic address: jehuda.soleman@gmail.com.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

29679781

Citation

Licci, Maria, et al. "Frontoethmoidal Osteoma With Secondary Intradural Mucocele Extension Causing Frontal Lobe Syndrome and Pneumocephalus: Case Report and Review of Literature." World Neurosurgery, vol. 115, 2018, pp. 301-308.
Licci M, Zweifel C, Hench J, et al. Frontoethmoidal Osteoma with Secondary Intradural Mucocele Extension Causing Frontal Lobe Syndrome and Pneumocephalus: Case Report and Review of Literature. World Neurosurg. 2018;115:301-308.
Licci, M., Zweifel, C., Hench, J., Guzman, R., & Soleman, J. (2018). Frontoethmoidal Osteoma with Secondary Intradural Mucocele Extension Causing Frontal Lobe Syndrome and Pneumocephalus: Case Report and Review of Literature. World Neurosurgery, 115, 301-308. https://doi.org/10.1016/j.wneu.2018.04.071
Licci M, et al. Frontoethmoidal Osteoma With Secondary Intradural Mucocele Extension Causing Frontal Lobe Syndrome and Pneumocephalus: Case Report and Review of Literature. World Neurosurg. 2018;115:301-308. PubMed PMID: 29679781.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Frontoethmoidal Osteoma with Secondary Intradural Mucocele Extension Causing Frontal Lobe Syndrome and Pneumocephalus: Case Report and Review of Literature. AU - Licci,Maria, AU - Zweifel,Christian, AU - Hench,Jürgen, AU - Guzman,Raphael, AU - Soleman,Jehuda, Y1 - 2018/04/19/ PY - 2018/02/14/received PY - 2018/04/09/revised PY - 2018/04/10/accepted PY - 2018/4/22/pubmed PY - 2018/8/1/medline PY - 2018/4/22/entrez KW - Frontal lobe syndrome KW - Mucocele KW - Paranasal sinus osteoma KW - Tension pneumocephalus SP - 301 EP - 308 JF - World neurosurgery JO - World Neurosurg VL - 115 N2 - BACKGROUND: Paranasal sinus osteoma is a common, asymptomatic, histologically benign, slow-growing tumor. However, it can give rise to secondary pathologies such as a mucocele in about 50% of the cases. Rarely, intracranial and orbital extension is present, leading to rhinoliquorrhea, pneumocephalus, or neurologic and visual impairment, which might be potentially life-threatening. CASE DESCRIPTION: A 49-year-old man presented with an acute frontal lobe syndrome and rhinoliquorrhea. Cranial magnetic resonance tomography showed a suspected frontoethmoidal osteoma with a mucocele expanding intradurally into the left frontal lobe. It was accompanied by pneumocephalus and showed communication with the left lateral ventricle. Through a bifrontal craniotomy, in toto resection of the frontoethmoidal bony tumor and the intradural mucocele was performed, while thereafter the frontal sinus was cranialized using a pedunculated periosteal flap. Postoperative recovery was uneventful with complete resolution of the tension pneumocephalus and rhinoliquorrhea and led to an improvement of the frontal lobe syndrome. CONCLUSIONS: We present a rare case of pneumocephalus caused by a frontoethmoidal osteoma associated with an intradural mucocele. A review of the literature, focusing on the surgical strategies in such cases, is provided. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/29679781/Frontoethmoidal_Osteoma_with_Secondary_Intradural_Mucocele_Extension_Causing_Frontal_Lobe_Syndrome_and_Pneumocephalus:_Case_Report_and_Review_of_Literature_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(18)30789-7 DB - PRIME DP - Unbound Medicine ER -