Endoscopic modified Lothrop procedure: an alternative for frontal osteoma excision

Abstract

<h4>Purpose</h4>To describe three cases of frontal osteoma which were safely removed with a stereotactic-assisted, endoscopic modified Lothrop approach (EMLP).<h4>Method</h4>Retrospective case review.<h4>Results</h4>Three patients presented with extensive frontal sinus osteomas. Two underwent an EMLP and one patient with osteoma extending significantly into the orbit had an EMLP for removal of the medial frontal sinus component combined with an anterior orbitotomy to remove the orbital extension. In all cases stereotactic localization was utilized to ensure preservation of the skull base. Post-operatively, one patient required debridement of oedema at the junction of a lateral mucocele and the frontal sinus. The other two patients remained well post-operatively with no complications. At follow-up, there was no tumour recurrence.<h4>Conclusion</h4>A stereotactic-assisted, EMLP with or without an orbital approach may be considered for the removal of large frontal osteomas and may provide a less invasive alternative to traditional external approaches.