Introduction: Osteoma is the most common benign paranasal sinus tumour. In majority of cases, it is asymptomatic and is
diagnosed by chance. We report on a case of giant frontoethmoidal osteoma with intraorbital and intracranial spread. Combined
surgical approach was chosen for management of this case. Immediate reconstruction of medial orbital wall and anterior skull base
Case Description: 25 years old man presented to otorhinolaryngology department due to incidental computed tomography
finding. Giant osteoma of the right frontoetmoidal region spreading into an orbit and anterior cranial fossa was identified on
computed tomography. The patient was absolute candidate for surgical treatment. Magnetic resonance imaging was performed to
view possible involvement of adjacent intraorbital and intracranial anatomical structures. Right side orbitozygomatic craniotomy
and endonasal endoscopic surgery were performed for removal of osteoma. On control computed tomography 12 months after
surgery there were no pathological changes or reccurrence of osteoma.
Conclusion: Surgical approach for osteoma management should be chosen according to its size, localization and involvement
of adjacent anatomical structures. For giant osteomas, spreading outside paranasal sinuses, endoscopic approach perspectives are
limited. Multidisciplinary approach is of a vital importance to achieve the best treatment outcome.