Osteoma: causes, treatment — bone, frontal sinus
An osteoma is called a benign tumor growing from bone tissue. This neoplasm is usually diagnosed in children and adolescents is approximately 10% of all tumors of bone origin and can occur without clinical manifestations, showing up randomly.
Many have heard about the bone tumors that appear suddenly, grow quickly and over a short period of time can lead to serious consequences. However, having had dense formation on the bones, we should not panic: the high probability that it will be the usual osteoma or osteophytes, do not pose a danger and threat to life. Often, benign tumors of bone are a godsend and are detected during x-ray examination regarding the injury or other pathology.
The basis of the tumor is bone, is more dense than the norm, and favorite localization – the bones of the skull and long bones of the limbs. These tumors can be detected in the paranasal sinuses – frontal, maxillary, sphenoid, ethmoid. Sometimes I marvel at the body of the vertebrae.
Since the tumor is in the bone, similar in structure to normal, the tumor nature of the tumor continues to be challenged. Moreover, the majority of osteomas of the long bones of the limbs in a detailed examination and does appear osteochondral exostosis – like projections do not have symptoms of cancer.
Among patients with benign tumors of the skeletal system is dominated by children, adolescents and young people, in whom the tumor is very slow growing and asymptomatic years, and the favorable Outlook is due to the inability of neoplasia malignant, metastasize and grow into the surrounding tissue. Men are more prone to bone tumors, but osteoma facial bones more often diagnosed in women.
As a rule, the osteoma is detected as a single lesion, but multiple growth is observed in hereditary pathology — the so-called Gardner syndrome, osteoma when combined with intestinal polyps and soft tissue tumors.
Causes and types of osteomas
The reasons for the growth of bone tumors has not been fully elucidated, but it is assumed that the basis of this pathological process can be repeated trauma and genetic predisposition. There are data on the role of such diseases as rheumatism, gout and even syphilis, but in these cases the bones of exostosis found that is not actually a tumor. Of some importance in the occurrence of osteomas of the paranasal sinuses is given to chronic inflammatory processes ENT organs and injury associated with puncture of the maxillary sinus in patients with recurrent sinusitis. Does not exclude the role of violations of fetal development under the influence of infectious agents, as well as the impact of pathologies of calcium metabolism and even adverse environmental conditions.
Depending on the characteristics of the structure are usually distinguished:
- Cancellous osteoma.
Compact osteoma is more characteristic of the bones of the skull consists of bone masses of lamellar structure, while the structure of cancellous osteoma presents scattered bone beams, and found this kind of in long tubular bones.
In traumatology distinguish hyperplastic osteoma, which originate in bone tissue, and heterotopic, the source of which is connective tissue. If hyperplastic osteomas are detected only in the bone, heterotopic can start its development in places of fastening of the tendons, muscles, brain, pericardium, and diaphragm.
A separate kind of benign osteoma is osteoid osteoma, which is highly differentiated, but has a special structure: among the scattered beams of bone have foci of destruction of bone and fragments very rich in vessels. This structure allows some researchers to attribute it to inflammatory and destructive processes, rather than to the tumors.
Osteogenic osteoma is more frequently accompanied by clinical manifestations in the form of pain, although it rarely exceeds 1 cm in patients dominated by men under 30 years who have revealed an osteoid osteoma of the tibia and the femur.
Often to bone tumors identify osteophytes and exostosis, which is a growth of bone tissue as a result of trauma, inflammatory changes, excessive mechanical loads or arising without apparent reason. Exostosis amaze pelvis, impeding the passage of the fetus through the birth canal of women, their localization in the cranial bones creates a cosmetic defect, and lesions of structures of the foot leads to pain and lameness.
The symptoms of osteoma
Osteoma is usually asymptomatic, especially if located on the surface of the bone and is small in size. Such a tumor is detectable in the form of a dense tumor with clear boundaries, the fabric in the region of the tumor, painless and movable, and the tumor may be only a cosmetic defect. However, some localization of the tumor may cause quite serious violations.
The most dangerous tumors of the skull, growing from the inner side, the sinuses and parts of the bones inside the skull. Such a tumor without looking at his purity, can cause severe headaches, increased intracranial pressure and seizures when stimulation of appropriate parts of the brain. With the defeat of the Sella it is possible to compression of the pituitary tissue, then in the forefront among the manifestations will come of the symptoms of endocrine disorders.
Osteomas of the facial skeleton often characterized by the frontal bone. They are easy to spot with the naked eye in the form of rounded protrusions on his forehead. Anxiety such tumors do not deliver, but the cosmetic defect can be the reason for surgical intervention.
The defeat of the frontal sinus occurs quite frequently, but suspected neoplastic nature of the disease can be difficult without the use of special studies. Osteoma this location for a long period of time can manifest itself in persistent headaches, blurred vision, change of voice.
If the tumor originated in jaw bones, their possible deformation, the displacement of eyes in lesions of the upper jaw, pain due to compression of branches of the trigeminal nerve. When osteoma of the mandible in the growth of tumors result in deformation of the bones and difficulty in opening the mouth.
Osteoid osteoma has some differences in its manifestations. It is characterized by:
Osteoid osteoma affects the long bones of the extremities (tibia, femur, shoulder), somewhat less involved vertebrae, and the sternum and the rib are suffering extremely rare.
Diagnosis and treatment of osteomas
To see a dense formation on the bone, you need to go to the doctor (traumatologist, orthopedist, surgeon) who will examine it, feel out and send in the necessary research. Very slow growth and the absence of any symptoms speaks in favor of the purity of the process, so many patients do not rush to the doctor, however, to ensure that no dangerous changes.
The basic method to detect any tumor of the bone, including osteoma, is radiography. If the tumor is situated deeply in the tissues of the head, small in size, it affects the bones of the skull from the inside, it is advisable to produce a CT scan, which gives more information about its size and location.
Among the safer procedures you can mark an ultrasound, which is often undeservedly neglected. Of course, not all of the tumor allows to diagnose with ultrasound, but, for example, surface osteomas of the skull may be detected on ultrasound. For this study requires the participation of experienced professionals with expertise in the diagnosis of bone tumors.
In the blood of patients with osteomas possible leukocytosis, accelerated erythrocyte sedimentation rate, signs of electrolyte imbalance, but most often no change occurs. In some cases there is the need for a biopsy, but benign tumors it is practically not used.
When the diagnosis is clear, and it is an osteoma, the physician needs to determine the necessary treatment. Feasibility of operation is determined by the presence of clinical manifestations and dysfunction of any of the bodies. In most cases, experts suggest to observe the situation and wait and see tactics.
Treatment of osteomas involves their removal, but only if appropriate. For example, tumors of the ear canal, sinuses, extremities, jaws cause some symptoms, so it’s best to get rid of them. If the osteoma is localized on the surface of flat bones of the skull, a surgical operation can be performed for purely cosmetic reasons.
Osteomas that do not cause concern and does not change the appearance of the person, just to observe. So, if the tumor is located in the area of hair growth-it is only when the feeling, there is no need to subject a patient to surgical operations and cosmetic effect in this case is highly questionable.
Conservative treatment in respect of osteomas does not exist. Do not get carried away and folk medicine, which is absolutely inefficient in the case of bone tumors. It is better to consult a specialist who will determine whether there is a need in the removal of tumors or you can simply observe its behavior. Treatment of osteomas involved physicians, traumatologists, and in the case of bone lesions of the skull and facial skeleton are involved neurosurgeons and maxillofacial surgeons.
Video: simple surgery to remove the osteoma of the frontal bone
Video: endoscopic removal of osteoma of the frontal bone
Video: operation to remove a large osteoma of the frontal sinus
Video: simple removal of the osteoma of the mandible
The prognosis of the osteomas is always good, and after the operation it is possible to achieve stable recovery. The tumor becomes malignant in a form that does not damage the surrounding tissue and not metastasize, so if the doctor recommends surgery, we can easily agree on dynamic observation.