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 is located inside the nose or at the ethmoid bone (lat. Os ethmoidale or Os ethmoides; place of passage of the nervi olfactorii/smell nerves into the nose), such as:
- Anosmia (lack of smell)
- Nasal discharge
- Sinusitis (inflammation of the sinuses)
- Ocular discomfort when the osteoma oppresses cranial nerve exits, such as:
- Diplopia (double vision, double images).
- Exophthalmos (protrusion of the eyeballs) due to displacement of the optic nerve
- Feeling of pressure in the nose or head (depending on localization).
Localization
Typical of primary bone tumors is that they can be assigned to a characteristic localization in addition to a certain age range. They arise clustered at the sites of most intense longitudinal growth (metaepiphyseal/articular area).
The following questions should be answered by diagnostic measures:
- Localization in the skeleton → Which bone is affected?
- Localization in the bone → epiphysis* (joint end of the bone (near the joint)), metaphysis* (transition from epiphysis to diaphysis), diaphysis* (long bone shaft), central, eccentric (not central), cortical (at the solid outer shell of the bone), extracortical, intraarticular (within the joint capsule).
Osteoma is mainly localized in the cranial bone, especially in the paranasal sinuses, but also occurs in the facial skull (inside the nose), sinus bone and ethmoid bone, as well as in the skeleton of the trunk and extremities.
* Example of the structure of a long bone: epiphysis – metaphysis – diaphysis – metaphysis – epiphysis.
