The medical history (history of the patient) represents an important component in the diagnosis of osteoma. Family history Are there any diseases in your family that are common? (Tumor diseases) Social anamnesis Current medical history/systemic history (somatic and psychological complaints). Do you suffer from headaches? Do you have a feeling of pressure in the nose … Osteoma: Medical History
Respiratory System (J00-J99) Maxillary sinus empyema – accumulation of pus in the maxillary sinuses. Maxillary sinus mycosis – fungal disease of the maxillary sinuses. Jaw cysts Pneumosinus dilatans (rare) – dilatation (widening) of the paranasal sinuses due to a dysfunctional valve mechanism, which allows the inflow of air Sinusitis (inflammation of the paranasal sinuses). Neoplasms … Osteoma: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by an osteoma: Respiratory system (J00-J99) Obstruction of the excretory duct of the paranasal sinus → paranasal sinus mucocele (mucocele = accumulation of mucus). Musculoskeletal system and connective tissue (M00-M99). Decreased bone growth Psyche – nervous system (F00-F99; G00-G99) Endocranial complications … Osteoma: Complications
Osteomas can be classified as follows: Classic osteoma Exclusively in the connective tissue-preformed bones of the skull: frontal sinus (sinus frontalis), ethmoid bone (Os ethmoidales), maxillary sinus (Sinus maxillaris). Juxtacortical (parosseous) osteoma. Predominantly on the outer surface of the long tubular bones (femur/thighbone). Medullary osteoma (synonyms: enostoma; enosteoma; compacta island). Cancellous bone
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin and mucous membranes Neck Extremities: [swelling? Size; consistency; displaceability of skin relative to underlying surface. Deformity of joints and bones?] Spine, thorax (chest). Gait pattern (fluid, limping) Body … Osteoma: Examination
1st order laboratory parameters – obligatory laboratory tests. Biopsy (tissue sample) – to determine dignity (benign/benign or malignant/malignant); osteoma resembles malignant parosseous osteosarcoma (this originates on the bone surface).
Therapeutic targets Relief of pain Removal of the tumor – see “Surgical Therapy“. Healing Therapy recommendations Analgesia according to WHO staging scheme: Non-opioid analgesic (paracetamol, first-line agent). Low-potency opioid analgesic (e.g., tramadol) + non-opioid analgesic. High-potency opioid analgesic (eg, morphine) + non-opioid analgesic.
Obligatory medical device diagnostics Conventional radiograph of the affected body region, in two planes – to assess the extent of tumor growth; the osteoma presents shadowing and sharply circumscribed Computed tomography (CT; cross-sectional imaging (radiographs taken from different directions with computer-based analysis)) – to determine the location, size, and extent of the tumor (bone destruction/destruction?) … Osteoma: Diagnostic Tests
Once an osteoma causes discomfort, it must be resected (surgically removed): Extirpation – complete surgical removal of the osteoma including filling of the bone defect with autologous (from the same individual) bone material (e.g., from the iliac crest), if necessary stabilization with metallic implants (intramedullary nail, angle plate).
An osteoma is usually asymptomatic and therefore usually an incidental finding on X-ray. The following symptoms and complaints may indicate an osteoma: Main symptoms Headache that slowly increases in intensity and occurs sporadically. Protrusion of the wall of the paranasal sinus – with larger osteoma. Complaints of the nose and paranasal sinuses, if the osteoma … Osteoma: Symptoms, Complaints, Signs
Pathogenesis (disease development) Osteoma consists of a localized neoplasm (new formation) of bone substance with a predominantly lamellar structure. It is a pedunculated bone tumor of spongy (sponge-like) structure (osteoma medullare) or of compact structure (osteoma durum) and is one of the osseous tumors. Etiology (causes) The exact causes of osteoma are still unclear.
General measures Nicotine restriction (refraining from tobacco use). Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day). Limited caffeine consumption (max 240 mg of caffeine per day; equivalent to 2 to 3 cups of coffee or 4 to 6 cups of green/black tea). Aim for normal weight! … Osteoma: Therapy
