Osteoma refers to a benign bone tumor. It often shows up in the skull region such as the sinuses.
What is an osteoma?
Osteoma belongs to the group of benign bone tumors. Bone tumors refer to growths that develop in bone tissue. There are both benign and malignant bone tumors. In contrast to bone cancer, however, an osteoma does not cause degeneration of the affected tissue. In addition, it does not lose its original function. In addition to osteomas, osteochondromas are also benign bone tumors. A typical feature of osteoma is its pedunculated appearance. Furthermore, the benign bone tumor has a spongy and pedunculated appearance. In medicine, a distinction is made between three different types of osteoma. There is the solid osteoma (osteoma durum), the spongy osteoma (osteoma spongiosum) and the brain-prominent osteoma (osteoma medullosum). It has a larger cavity that contains bone marrow.
Causes
In principle, osteomas can form in any part of the skeleton. In most cases, however, they occur on the skull. The frontal sinus region is particularly affected. Occasionally, they also occur on the ethmoid bone (Os ethmoidale) or the maxillary sinus (Sinus maxillaris). The causes for the development of an osteoma vary. However, in many patients, no exact cause can be determined. Osteomas arise from mature bone and are either compact or spongy. The compact osteoma is composed exclusively of bone. It is not uncommon for it to be a concomitant of benign tumors on the meningiomas (soft meninges). The composition of a spongy osteoma is bone and cavities. Sometimes they occur in the context of hereditary diseases such as Gardner syndrome. Gardner syndrome is characterized by cranial osteomas, skin tumors, and intestinal polyps. Furthermore, additional bone fibromas form near the osteomas. These originate in the connective tissue. In addition, bone hemangiomas are present, which arise from the vessels. Biochemical, physical or chemical processes are discussed as possible triggers of osteomas. However, evidence could not be found so far. A possible connection is seen to rapid bone growth. Thus, benign bone tumors develop predominantly at an age between 20 and 30 years.
Symptoms, complaints, and signs
Osteoma can cause a variety of symptoms. Most patients suffer from headaches that increase in intensity over time. At the paranasal sinuses, a protrusion of the affected walls sometimes develops. Furthermore, the osteoma threatens to obstruct the excretory duct of the paranasal sinus. This in turn favors the formation of a paranasal sinus mucocele. It is not uncommon for the mucocele to cause a feeling of pressure inside the head. Likewise, limitations of visual acuity as well as double vision are within the realm of possibility. Osteoma may also cause displacement of the eyeball. If the benign bone tumor extends further, this leads to tissue atrophy at the dura mater (hard meninges). This poses a risk of endocranial complications. Other conceivable complaints are the accumulation of fluid in an osteoma close to a joint, the inhibition of bone growth, deformations of bones and joints, pressure damage to nerves or vessels, bone fractures, and pain at the affected body site. The symptoms also depend on the type of tumor and its body location.
Diagnosis and disease progression
The symptoms also play a significant role in a medical examination. Thus, it provides the first indications of the disease, which is especially true for bone deformities. As part of the examination, the attending physician performs various pain and function tests. These include a stress test or a check of the blood circulation. An osteoma can be reliably diagnosed by the typical changes that can be seen on an X-ray. If there is still doubt as to whether the tumor is benign or malignant, further examinations must be performed. These include a computer tomography (CT) and a magnetic resonance imaging (MRI). Furthermore, it is possible to take a tissue sample (biopsy), which is then examined under a microscope. The exact position of the bone tumor also provides important information.Thus, osteomas often show up in certain parts of the body. It is also important to make a differential diagnosis with other diseases that present similar complaints. These include, first and foremost, ostitis fibrosa, in which there is painless reaming of the forehead and the upper jaw bone. Since osteomas are benign bone tumors, their course is usually positive. Occasionally, an osteoma may recur.
Complications
Affected individuals primarily suffer from very severe headaches as a result of the osteoma. As a rule, these headaches occur without any particular reason and, above all, very sporadically. Furthermore, there are also very unpleasant feelings of pressure in the head and also in the nose. As a result, it is not uncommon for the patient’s ability to concentrate to be significantly reduced, so that the child’s development may also be restricted. The field of vision is also not infrequently restricted and considerably reduced by the osteoma. The osteoma also leads to reduced bone growth, so that complete healing does not occur, especially after accidents or fractures. Furthermore, however, the symptoms and the further course of this disease depend very much on the exact position and the exit of the tumor, so that a general prediction about the complications can usually not be made. Osteoma is treated by surgical intervention. Complications usually do not occur. It is possible that the affected person will then have to rely on implants. If treatment is successful, there is no effect on the patient’s life expectancy.
When should you see a doctor?
Undefinable pain, deformity of joints and bones, and pressure damage to joints must be evaluated by a physician. These symptoms indicate an osteoma, which must be diagnosed and treated by a physician. Affected individuals are best advised to talk to their family doctor, who can already make a tentative diagnosis based on the patient’s medical history and a physical examination. If there is indeed an underlying osteoma, an orthopedist will be involved in the treatment. If movement damage has already occurred, a physiotherapist or a sports physician is also involved in the therapy. People who have had cancer before should see a doctor immediately if they show any of the above signs. The same applies to genetic predispositions, which increase the probability of developing benign bone tumors. If a parent has a history of osteoma or osteochondroma, it can be passed on to the children. Therefore, corresponding high-risk patients should see a doctor immediately if the above symptoms occur. If the osteoma is treated early, the condition can usually be overcome without long-term consequences. If it is treated late or inadequately, it can lead to restricted mobility and severe pain. In the long term, the tumor can spread and even lead to death.
Treatment and therapy
Treatment of an osteoma depends on whether or not it causes symptoms. Any complications and the patient’s age are also important. If the growth of the tumor progresses slowly and there are no symptoms, it is usually waited and the further course is observed. If necessary, surgery is performed on the osteoma. In doing so, the surgeon ensures that the procedure is as gentle as possible. During the surgical procedure, the surgeon uproots and removes the osteoma from the body, which is also called extirpation. If necessary, a replacement can also be inserted using the body’s own tissue or artificial implants.
Outlook and prognosis
The prognosis for osteoma is usually very favorable. In most cases, it is possible to wait to see how the bone tumor develops. Surgical removal is usually not necessary in these cases. The osteoma grows very slowly and usually does not cause any symptoms. In a small fraction of cases, it degenerates into a malignant bone tumor. After timely surgical removal, however, the prognosis is relatively good even for such a tumor. On the other hand, an osteoma can become problematic if it is located in the area of the eyes, the nose or the paranasal sinuses. Some discomfort or impairment may occur at these sites. However, these are usually not life-threatening. In most cases, surgery is nevertheless advisable in such cases, which achieves reliable results.Rarely, such an intervention is not possible. Nevertheless, the prospects for affected patients are relatively good. After removal of the osteoma, recurrence of benign bone tumors within the first few years after surgery occurs in very few cases. Subsequent recurrence, on the other hand, is relatively unlikely.
Prevention
Preventive measures designed to prevent osteoma are not known. Therefore, if noticeable deformities or discomfort appear, it is important to consult a physician as soon as possible to determine the causes. In this way, further impairments such as bone fractures can be prevented.
Aftercare
Follow-up care is an inevitable part of any cancer treatment. A tumor that has been successfully treated may develop a recurrence at the same site after some time. This results in renewed symptoms and the risk of a shortened life expectancy. For this reason, the tumor should be monitored closely. Doctors expect the best therapeutic success from an early start of treatment. Although an osteoma is a benign tumor that does not tend to metastasize, follow-up care is still necessary because it can cause discomfort. Doctors initially refrain from surgery as long as there are no everyday restrictions. During this time, regular routine check-ups are required. Scheduled follow-up visits are also indicated after surgery because of the possibility of recurrence. The location and extent of follow-up care is determined jointly by the physician and the patient. In most cases, a check-up every six months is sufficient. Imaging procedures such as X-rays or a CT scan are particularly suitable for determining the progress of the disease. Due to the technical requirements, follow-up care usually takes place in clinics. Fine tissue examinations can also lead to a diagnosis. If surgery is performed, rehabilitation is often part of the aftercare. The patient is specifically prepared by therapists for his professional and social reintegration.
What you can do yourself
Osteoma patients can do a few things to support medical therapy and improve their own well-being. Light and regular exercise strengthens the immune system, cardiovascular system and hormonal balance. Depending on where the tumor is located, swimming and running, but also cycling, walking or even moderate muscle training are suitable. Alternative measures such as yoga, tai chi and qi gong have also proven to be of supportive help for osteomas. It is important to strike a balance between exercise and rest. If the doctor prescribes bed rest, this should be adhered to. The diet should be composed of foods rich in vital nutrients and minerals. Vegetables, fruits, nuts and seeds help to quickly regain fitness after chemotherapy or radiation therapy. These general measures can be supported by exchanges with like-minded people. In a self-help group or on Internet forums, osteoma patients can talk to others affected about the symptoms and problems. It is equally important to maintain social contacts. Hobbies and passions provide a counterbalance to the serious aspects of the disease and help maintain a high quality of life despite the disease. During and after treatment, it is important to reduce stress through relaxation exercises such as autogenic training or progressive muscle relaxation. This reduces physical discomfort and mental anguish in equal measure.