额筛区骨瘤属良性肿瘤,生长缓慢。肿瘤小且无症状者可不予切除而行放射学随访观察,瘤体较大且引起症状者则应切除。手术进路依肿瘤体积大小、部位和侵及范围而定,较小者可直接经Howarth-Lynch切口进路,较大者可经鼻侧切开,但偶遇巨大额筛区骨瘤,以上入路不能适用,因为视野小难以切净,且可遗留难以处置的骨折或脑脊液漏。经颅面联合入路可避免这些问题,以下结合一个病例说明手术步骤。患者男性,37岁,病史、体检、鼻窦X线及CT检查确诊为额筛区巨大骨瘤,侵及两侧额、筛窦及颅前窝。手术经右侧鼻侧切开,向上延长切口至额部中线,暴 Frontal area osteoma is a benign tumor, slow growth. Small tumors and asymptomatic patients may not be removed and radiological follow-up observation, the tumor larger and cause symptoms should be removed. Surgical approach according to tumor size, location and extent of invasion may be, the smaller person may directly through the Howarth-Lynch incision approach, the larger one can be cut through the nose, but occasionally encountered a large sieve area of ​​the tumor, the above Road can not be applied, because the vision is difficult to cut a small net, and can leave a difficult to handle fractures or cerebrospinal fluid leakage. Transcranial approach to avoid these problems, the following combination of a case of surgical procedures. Male, 37 years old, medical history, physical examination, paranasal X-ray and CT examination were diagnosed as giant bone tumors in front of the screen area, both sides of the frontal invasion, ethmoid sinus and anterior fossa. Surgery by the right side of the nasal incision, extending the incision to the forehead midline, violence