Osteoma of the Frontal Sinus
Although osteoma of the frontal sinus is not rare, the following 2 cases present some features of special interest. Osteomata are usually found on routine examination in the early stage, as in the first examination of case 1, or not until they have produced symptoms, as in case 2. The opportunity seldom arises to observe their development from innocent, rather unimportant findings to the obstructing, dangerous stage as in case 1. Osteomata are slow growing and usually do not reach a size that requires operative interference. Although they are more prone to increase in size during youth, the growth in case 1 occurred during the period between the ages of 38 and 46.
Case 1. A man, aged 36, was first seen on September 24, 1937, complaining of nasal congestion and chronic purulent postnasal drip. He had had a submucous resection seventeen years previously with some relief of nasal obstruction but with subsequent nasal crusting. Family history revealed that both grandfathers had suffered from asthma, one having had hay fever as well. The patient had had eczema in infancy and had noted sneezing and nasal congestion on exposure to horse hair and dust.
Examination showed a straight nasal septum with a large anterior perforation. Turbinates were edematous and pale. There was a large polyp in each middle meatus. The frontal sinuses were clear, the left antrum was dim and the right antrum dark on transillumination. The tonsils had been removed. The larynx was slightly injected but otherwise normal.