Drilling and Groove-cutting Technique for Safe and Complete Removal of Forehead Osteomas on the Anterior Table of the Frontal Sinus.

Abstract

Forehead osteomas are benign tumors commonly excised for cosmetic and functional reasons. However, removing osteomas from the anterior table of the frontal sinus presents specific challenges, particularly in determining the appropriate removal thickness. Inaccurate resection depth may result in fracture or perforation of the anterior table of the frontal sinus, or incomplete resection. The authors propose a novel drilling and groove-cutting technique to ensure safe and complete excision while minimizing risks of fracture or perforation of the anterior table. In this study, the authors present a 51-year-old female patient with a recurrent osteoma. Preoperative computed tomography (CT) imaging-guided depth-limiting drilling at the osteoma's center, followed by groove-cutting to establish excision boundaries. Then divided osteoma blocks were excised completely. Postoperatively, the patient showed no sensory deficits or forehead asymmetry and achieved pleasing frontal contour with minimal scarring. This technique effectively safeguards the anterior table and ensures complete removal, demonstrating its utility in craniofacial surgery.