Unilateral Endoscopic Endonasal Resection of an Anterior Skull Base Osteoma Causing Tension Pneumocephalus

Osteomas represent the most common benign neoplasm of the paranasal sinuses. Rarely, these tumors are symptomatic, and even more rarely, they present with complications including intracranial invasion with pneumocephalus. The surgical management of paranasal sinus osteomas causing intracranial complications, like pneumocephalus, has classically been described with open craniofacial approaches. Here, we discuss the management of a case of pneumocephalus caused by a large fronto-ethmoid osteoma. In this case, surgical management consisted of an entirely endoscopic, endonasal approach using only the left nasal and sinus cavity as the surgical corridor.