Frontal Sinus Osteoma Presenting with Meningitis and Epilepsy

Background: Osteomas are benign lesions of bone, most frequently seen in the paranasal sinuses; however, they are typically asymptomatic and without complication. We report a rare case of large frontal sinus osteoma with intracranial extension, associated with meningitis and the development of seizures. Case Description: The patient is a 38-year-old man with a prolonged history of headache and seizures, who was seen by multiple specialists previously, all of whom deferred treatment. After years of worsening seizure activity, he finally underwent surgical resection of the lesion at our institution in a joint operation with neurosurgery and otolaryngology. We examine his course, presentation, and management, and examine the literature for cases of complicated sinus osteomas. Conclusions: This represents the fourth reported case of frontal sinus osteoma associated with meningitis. We believe this case demonstrates the value of a robust differential and a multidisciplinary approach.