Pediatric benign paranasal sinus osteogenic tumors have previously been challenging to treat due to the developing skull’s surgical constraints. Progression may lead to intracranial complications or orbital and optic nerve compression.

Researchers conducted this study to assess the presentation and management of benign paranasal sinus osteogenic tumors.

The present study is a systematic review of these lesions’ symptoms and surgical treatment and a case series of two adolescents with osteomas impinging on the orbit treated with a multi portal approach.

Forty-eight cases of osteomas, osteoblastoma, or osteoid osteomas were reviewed from 43 articles. The average age was 14 years, 67% of tumors were osteomas, and 48% were more significant than 3 cm in the longest dimension. Compared to osteoblastoma, osteomas had a greater male to female ratio, presented at an older age with a smaller tumor burden (P = .003), and had prior trauma or surgery. The ethmoid, frontal, maxillary, and sphenoid sinuses were affected in decreasing order of frequency. On univariate logistics regression of patient demographics, tumor characteristics, and surgical approaches predictive of surgical outcomes, only tumor type was predictive of postoperative recurrence.

The study concluded that there was no association between surgical approach and postoperative complications or recurrence rate. However, a transnasal and transorbital multi portal approach avoids facial incisions.