전두동 골종에 의한 긴장성 기뇌종

A case of tension pneumocephalus associated with frontal sinus osteoma

Osteomas mainly affect the frontal and ethmoid sinuses, and are usually asymptomatic. When enlarged, they can give rise to intracranial manifestations and life-threatening complications. A 41-year-old man presented with severe headache and drowsy mentality after blowing his nose. Computed tomography showed air bubbles in the cisterns and the ventricle and around the osteoma in the frontal sinus, suggesting that the mass was associated with entry of the air into the cranial cavity. Through a frontal sinusotomy, the cauliflower-like osteoma was found to be protruding intracranially through the frontal base and the overlying meninges. By using skull base technique, the osteoma was resected radically and the dural defect was repaired with autografts. This rare condition should be urgently treated in the event of acute deterioration. The literature will be reviewed regarding the management of cranial base osteomas and their complications.