Surgical Removal of a Large Osteoma in the Frontal Bone and Treatment of Facial Fractures: An Integrated Approach
Matheus Felipe Lemes Metchko
Department of Dentistry, Ingá University Center - UNINGÁ, Maringá, Paraná, Address: Rod. PR 317, 6114 Parque Industrial 200, Maringá - PR, 87035-510, Brazil.
Ana Beatriz Kazmierski Morakami
Department of Dentistry, Ingá University Center - UNINGÁ, Maringá, Paraná, Address: Rod. PR 317, 6114 Parque Industrial 200, Maringá - PR, 87035-510, Brazil.
Ellen Constantino Berardi
Department of Dentistry, Ingá University Center - UNINGÁ, Maringá, Paraná, Address: Rod. PR 317, 6114 Parque Industrial 200, Maringá - PR, 87035-510, Brazil.
Heloisa Conti Checom
Department of Dentistry, Ingá University Center - UNINGÁ, Maringá, Paraná, Address: Rod. PR 317, 6114 Parque Industrial 200, Maringá - PR, 87035-510, Brazil.
Andressa Bolognesi Bachesk *
Department of Dentistry, Ingá University Center - UNINGÁ, Maringá, Paraná, Address: Rod. PR 317, 6114 Parque Industrial 200, Maringá - PR, 87035-510, Brazil and Department of Oral and Maxillofacial Surgery, Institución Universitaria Colegios de Colombia. UNICOC (Bogotá/Colômbia), Address: Km 20, Autonorte I-55, Chía, Cundinamarca, Colombia.
*Author to whom correspondence should be addressed.
Abstract
Osteoma is a benign osteogenic tumor of unknown etiology, with no predilection for nationality, race, gender, or age. It typically presents in small diameters, with large extensions being rare. The prognosis in these cases is closely tied to early diagnosis, often made during clinical inspections, identifying asymptomatic lesions or those associated with pain and asymmetry. For this reason, the dentist must be vigilant in identifying any abnormalities in patients, even those outside their specific field of practice. This paper aims to report a clinical case of a 56-year-old male patient with fair skin who presented to the hospital following facial trauma. After clinical and imaging examinations, he was diagnosed with multiple facial fractures as well as a large osteoma in the atypical region of the frontal bone, which caused visual interference on the right side. The integrated treatment involved a combination of bicoronal and circumvestibular approaches for the surgical removal of the osteoma, along with the stabilization and fixation of the frontozygomatic suture, Le Fort I fracture, and hemi-Le Fort II fracture using 2 mm titanium plates. After 5 years of follow-up, the patient remained free of complaints or sequelae, in good general health, and with no signs of recurrence. Although osteomas are often asymptomatic, in this case, the tumor caused significant facial asymmetry and visual disturbances due to the compression of adjacent structures, proportional to its size.
Keywords: Facial fracture, frontal bone, bicoronal approach, osteoma, osteogenic tumor