An unusual encounter in ophthalmology: Fronto-Ethemoido-Orbital Osteoma with the art of precise referral and management of PEEK implant infection- A rare case report

Purpose: We present a rare case of a giant fronto-ethmoidal osteoma with orbital involvement, managed through a multidisciplinary approach. This case also highlights the prompt reconstruction using a PolyEtherEtherKetone (PEEK) patient-specific implant (PSI) and the subsequent management of a PEEK i...

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Main Authors: Sawarkar Komal, Bhattacharjee Kasturi, Barman Paranjyoti, Gogoi Rahul
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:American Journal of Ophthalmology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2451993625000076
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author Sawarkar Komal
Bhattacharjee Kasturi
Barman Paranjyoti
Gogoi Rahul
author_facet Sawarkar Komal
Bhattacharjee Kasturi
Barman Paranjyoti
Gogoi Rahul
author_sort Sawarkar Komal
collection DOAJ
description Purpose: We present a rare case of a giant fronto-ethmoidal osteoma with orbital involvement, managed through a multidisciplinary approach. This case also highlights the prompt reconstruction using a PolyEtherEtherKetone (PEEK) patient-specific implant (PSI) and the subsequent management of a PEEK implant infection. Observation: We present a case of 34-year-old gentleman presented with progressive painless proptosis of left eye along with left sided headaches that he noticed for one year. CT scans suggestive of a large Fronto-Ethemoido-Orbital Osteoma seen to compressing the globe and superior rectus muscle. A multidisciplinary approach was chosen including an oculoplastic surgeon, maxillofacial surgeon and neurosurgeon to manage the case. A PEEK implant was used for the reconstruction of frontal and orbital bones, which later on got infected and a second surgery was done to explant the PEEK implant. Conclusion and importance: Asymptomatic osteomas without any orbital extension seldom requires any treatment. While secondary orbital invasion is relatively rare, it is more frequent in ethmoid, fronto-ethmoid, and frontal locations. Prompt treatment is crucial in the cases with orbital symptoms. In ophthalmology, there is a growing interest in using PEEK implants. While standard implants are usually adequate for routine repairs, complex cases with irregular defects or volume deficiencies present challenges. In these situations, patient-specific implants (PSIs) offer an invaluable solution.
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spelling doaj-art-9aca2d7d15a845e0bde7c1cf1d8d29192025-08-20T02:43:20ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362025-03-013710225410.1016/j.ajoc.2025.102254An unusual encounter in ophthalmology: Fronto-Ethemoido-Orbital Osteoma with the art of precise referral and management of PEEK implant infection- A rare case reportSawarkar Komal0Bhattacharjee Kasturi1Barman Paranjyoti2Gogoi Rahul3Department of Ophthalmic Plastic and Reconstructive Surgery, Sri Sankaradeva Nethralaya, Guwahati, Assam, India; Corresponding author. Fellow at Department of Ophthalmic Plastic and Reconstructive Surgery, SriSankaradeva Nethralaya, #96, Basistha Road, Guwahati, Assam, 781028, India.Department of Ophthalmic Plastic and Reconstructive Surgery, Sri Sankaradeva Nethralaya, Guwahati, Assam, IndiaDepartment of Neurosurgery, GNRC, Guwahati, Assam, IndiaRahul Gogoi Institute of Maxillo Facial Surgery, Guwahati, Assam, IndiaPurpose: We present a rare case of a giant fronto-ethmoidal osteoma with orbital involvement, managed through a multidisciplinary approach. This case also highlights the prompt reconstruction using a PolyEtherEtherKetone (PEEK) patient-specific implant (PSI) and the subsequent management of a PEEK implant infection. Observation: We present a case of 34-year-old gentleman presented with progressive painless proptosis of left eye along with left sided headaches that he noticed for one year. CT scans suggestive of a large Fronto-Ethemoido-Orbital Osteoma seen to compressing the globe and superior rectus muscle. A multidisciplinary approach was chosen including an oculoplastic surgeon, maxillofacial surgeon and neurosurgeon to manage the case. A PEEK implant was used for the reconstruction of frontal and orbital bones, which later on got infected and a second surgery was done to explant the PEEK implant. Conclusion and importance: Asymptomatic osteomas without any orbital extension seldom requires any treatment. While secondary orbital invasion is relatively rare, it is more frequent in ethmoid, fronto-ethmoid, and frontal locations. Prompt treatment is crucial in the cases with orbital symptoms. In ophthalmology, there is a growing interest in using PEEK implants. While standard implants are usually adequate for routine repairs, complex cases with irregular defects or volume deficiencies present challenges. In these situations, patient-specific implants (PSIs) offer an invaluable solution.http://www.sciencedirect.com/science/article/pii/S2451993625000076Fronto-ethemoidal osteomaOrbital reconstructionPEEK implantPatient specific implant
spellingShingle Sawarkar Komal
Bhattacharjee Kasturi
Barman Paranjyoti
Gogoi Rahul
An unusual encounter in ophthalmology: Fronto-Ethemoido-Orbital Osteoma with the art of precise referral and management of PEEK implant infection- A rare case report
American Journal of Ophthalmology Case Reports
Fronto-ethemoidal osteoma
Orbital reconstruction
PEEK implant
Patient specific implant
title An unusual encounter in ophthalmology: Fronto-Ethemoido-Orbital Osteoma with the art of precise referral and management of PEEK implant infection- A rare case report
title_full An unusual encounter in ophthalmology: Fronto-Ethemoido-Orbital Osteoma with the art of precise referral and management of PEEK implant infection- A rare case report
title_fullStr An unusual encounter in ophthalmology: Fronto-Ethemoido-Orbital Osteoma with the art of precise referral and management of PEEK implant infection- A rare case report
title_full_unstemmed An unusual encounter in ophthalmology: Fronto-Ethemoido-Orbital Osteoma with the art of precise referral and management of PEEK implant infection- A rare case report
title_short An unusual encounter in ophthalmology: Fronto-Ethemoido-Orbital Osteoma with the art of precise referral and management of PEEK implant infection- A rare case report
title_sort unusual encounter in ophthalmology fronto ethemoido orbital osteoma with the art of precise referral and management of peek implant infection a rare case report
topic Fronto-ethemoidal osteoma
Orbital reconstruction
PEEK implant
Patient specific implant
url http://www.sciencedirect.com/science/article/pii/S2451993625000076
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