Osteomas are benign lesions that develop from the mature bone tissue.In cases of surgical treatment of osteomas of the paranasal sinuses, various surgical approaches can be used.The type of surgical access depends on the size of the osteoma, its localization, place of attachment, degree of spread, as well as on the experience of the surgeon.Currently, the following approaches are distinguished: through the front wall of the frontal sinus; endonasal access using endovideotechnics; bicoronary access; combined access.In our article we present a clinical example of a giant osteoma of the ethmoidal labyrinth with intraorbital spread.At the Clinic of Otorhinolaryngology of the Pavlov First State Medical University in the period from January 2012 to May 2022, 209 surgeries were performed in patients with osteomas of the paranasal sinuses.Osteomas of the frontal sinuses were found in 89 cases, affection of the ethmoidal labyrinth was found in 76 cases, the maxillary sinus – in 38 cases, the sphenoid sinus – in 6 cases.Of all the osteomas after the surgery in 47 patients this type of tumor according to X-ray examination was attributed to the group of "giant" osteomas.In each clinical case, endoscopic osteoma removal was performed under guidance of the electromagnetic navigation system and under general anesthesia.Considering the above, it should be noted that proper preoperative preparation of comorbid patients, endoscopic intervention using a navigation system by an experienced rhinosurgeon and competent management of the postoperative period of patients in cases of removal of giant osteomas of the ethmoidal labyrinth with intraorbital spread are key factors contributing to successful treatment and reduction of recovery and rehabilitation time.
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