Secondary spontaneous cerebrospinal fluid leak rhinorrhea caused by osteoma on ethmoidal roof: A Case Report

Abstract

Introduction: Osteomas are benign osteogenic lesions. The most prevalent area of occurrence in the craniofacial skeleton is the frontal and ethmoid sinuses. Patients with paranasal sinus osteomas are usually asymptomatic, incidentally discovered and rarely can cause severe complications.
Clinical presentation: A 28-year-old man presented with a 6-month history of unilateral watery rhinorrhea with severe headache. He had a history of head trauma from 10 years ago. The CT scan demonstrated an osseous mass within the right roof of the ethmoid sinus with a direct intracranial extension into the anterior cranial fossa and severe pneumocephalus. The patient underwent functional endoscopic sinus surgery.
Conclusion: Osteomas are rare, benign tumours. In the area of the paranasal sinuses, they have a slow growth and asymptomatic course. The diagnosis is often made incidentally. In sporadic cases, they can cause orbital and intracranial complications, which should not be clinically underestimated.