Paranasal ossifying fibroma: endoscopic resection or wait and scan?

The ossifying fibroma is a fibro-osseous lesion that rarely occurs in the paranasal sinuses. Due to its tendency to behave locally aggressively, complete resection is generally recommended. A subdivision into the aggressive juvenile ossifying fibroma (JOF) and the less aggressive cemento-ossifying fibroma of the adult (COF) is clinically reasonable. The objective of the study was to retrospectively analyze the management and follow-up of the patients diagnosed with ossifying fibroma at our ENT-department from 2006 to 2010. A total of five patients were included, thereby comprising one of the largest case series of paranasal ossifying fibromas. In three patients an exclusively endoscopically controlled resection was performed. Two patients with asymptomatic COF declined surgery. Within the 2-year follow-up, no progression was detected. While the JOF should always be surgically treated, for the asymptomatic paranasal ossifying fibroma of the adult (COF) a wait-and-scan strategy, similar to that recommended for osteomas or fibrous dysplasia, could be an option in selected cases.