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Chronic osteomyelitis of the skull base is a commonly reported pathology in existing scientific literature, but chronic osteomyelitis of the skull vault (COSV) is a rarely documented disease. We report the case of a 38 years old Afghan male with a presenting complaint of irregular swelling on the skull vault for six months. The patient had a history of head trauma one year back with a compound depressed fracture which had been surgically managed then.

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External auditory canal osteoma with coexisting canal wall cholesteatoma: a case report and review of literature.

J Med Case Rep

December 2024

Department of Otorhinolaryngology and Head and Neck Surgery, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.

Background: Though rare, benign lesions that usually do not necessitate active intervention, osteomas of the external auditory canal, can be troublesome when they start to produce mass effect and severe obstruction to the external auditory canal. Even more insidious is the rarer phenomenon of canal wall cholesteatomas, which have been known to cause significant canal erosion and if left unchecked and spontaneous destruction of the adjacent anatomical structures, including the facial nerve, temporomandibular joint, sigmoid sinus, and skull base. The occurrence of both these exceptionally uncommon findings in the same canal is an unusual finding and may point to an undetermined interplay in pathogenesis.

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Article Synopsis
  • - Osteomas are the most frequent benign tumors found in the sinonasal area and are often discovered incidentally during unrelated imaging studies; larger versions over 30 mm are termed "giant" osteomas and can lead to complications if they invade nearby spaces.
  • - This report details a case involving a 30-year-old woman with a 45 mm fronto-ethmoidal osteoma causing pressure on her eye and frontal lobe, requiring a specialized surgical team of ENT and neurosurgeons for treatment.
  • - The goal of treating giant sinonasal osteomas is complete surgical removal through a combined approach, and while the risk of recurrence exists, outcomes can vary based on the surgical methods used.
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  • * A total of 13 cases were reviewed, revealing that EEA was the primary technique used for most tumors, particularly those located near the optic nerve, with additional approaches (TOA and EMMM) employed as needed for extraconal tumors.
  • * The results showed an 80% gross-total resection rate and a 69.2% improvement in visual function after surgery, indicating that the combined surgical methods are both safe
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Article Synopsis
  • * Males are more frequently affected by osteomas, which can occur at any age, and patients may also have Gardner syndrome, a genetic condition linked to various dental and skeletal issues.
  • * The article discusses the rarity of mandibular osteomas and their differential diagnosis, noting the importance of monitoring for related conditions like gastroenteric polyps that could lead to malignancy.
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