Year: 2026 | Month: April-June | Volume: 11 | Issue: 2 | Pages: 189-193
DOI: https://doi.org/10.52403/ijshr.20260223
A Rare Case of Giant Dumbbell-Shaped Frontoethmoidal Osteoma with Medial Orbital Wall Involvement: Surgical Excision and Reconstruction
Milind M. Navalakhe1, Anoushka Sahai2, Kapil Agrawal3, Prateek Mohapatra4, Rutvi Patel5
1Professor in the Department of ENT and Head-Neck Surgery, Seth G.S. Medical College and KEM Hospital, Mumbai, India
2Assistant Professor in the Department of ENT and Head-Neck Surgery, Seth G.S. Medical College and KEM Hospital, Mumbai, India.
3Professor in the Department of Plastic and Reconstructive Surgery, Seth G.S. Medical College and KEM Hospital, Mumbai, India
4Senior resident in the Department of ENT and Head-Neck Surgery, Seth G.S. Medical College and KEM Hospital, Mumbai, India
5Assistant Professor in the Department of ENT and Head-Neck Surgery, Seth G.S. Medical College and KEM Hospital, Mumbai, India.
Corresponding Author: Dr Anoushka Sahai
ABSTRACT
Introduction: Frontoethmoidal osteomas are rare benign tumors that may cause functional and cosmetic morbidity when large. Surgical excision is indicated for symptomatic or giant osteomas, particularly those involving the orbit or frontal recess. We present a rare case of a giant dumbbell-shaped frontoethmoidal osteoma with medial orbital wall involvement, managed with external excision and autologous rib graft reconstruction.
Case Report: A 17-year-old female presented with progressive forehead swelling and frontal headache for 4 months. Clinical examination revealed a firm supraorbital swelling, and CT imaging showed a homogenous, ossified, dumbbell-shaped lesion involving the left frontal and ethmoid sinuses, with thinning of the medial orbital wall and indentation of the medial rectus. The patient underwent complete excision through a Lynch-Howarth approach. Due to orbital wall loss, medial wall reconstruction was performed using a novel “papyrus graft” fashioned from autologous rib, shaped into thin plates and sutured to periosteum. Postoperative recovery was uneventful with no ocular morbidity, and graft survival was confirmed on CT at 3 weeks.
Conclusion: Giant frontoethmoidal osteomas are rare and may demand complex reconstruction after excision. External approach combined with autologous rib grafting provides effective tumor clearance and durable orbital wall reconstruction with excellent functional and cosmetic outcomes.
Keywords: Frontoethmoidal osteoma, paranasal sinus tumor, orbital wall reconstruction, rib graft, Lynch-Howarth incision, papyrus graft.