Endoscopic Surgery Offers New Promise for One of the Rarest Sinonasal Tumors

Sinonasal osteoblastoma is among the rarest bone tumors of the head and neck, accounting for less than 1 percent of all maxillofacial tumors. Because so few cases exist worldwide, most of the available knowledge comes from isolated case reports. This has left clinicians with limited guidance on how to diagnose and manage the disease, especially when tumors extend near critical structures such as the orbit or skull base.

Patients typically present with symptoms like nasal obstruction, persistent headaches, or epistaxis. In advanced cases, the tumor may expand toward the eye or anterior skull base, which historically pushed surgeons toward open external approaches. These operations often carried risks of scarring, cosmetic deformity and recurrence, making decision-making challenging for both patients and surgeons.

To address this lack of evidence, Dr. Goran led a EurAsia Group initiative that produced one of the largest single-institution series on sinonasal osteoblastoma to date. The team studied five patients, aged 12 to 57 years, all of whom were treated using a fully endoscopic sinus surgery approach. Four tumors were completely excised. One extensive frontal sinus tumor underwent planned subtotal resection to avoid unnecessary neurological or facial risk. Over two to five years of follow-up, none of the patients experienced recurrence or major complications.

These findings are significant because they demonstrate that endoscopic sinus surgery can be both safe and effective for managing sinonasal osteoblastomas, even when the lesions are adjacent to delicate anatomical structures. The study adds valuable data to an area of the literature that previously relied almost exclusively on single case descriptions.

The full results were published in the European Archives of Oto-Rhino-Laryngology, a Springer journal, you can find it here.