LAUSR

have read with the great interest the article entitled ‘Giant fronto-ethmoidal osteoma -selection of an optimal urgical procedure’’ by Maria Humeniuk-Arasiewicz et al.1 According to the definition used by the authors ‘‘giant steomas’’ are these measuring more than 30 mm. Although uggested by the title and mentioned in ‘‘objective’’ secion, the authors presented a review of 37 osteomas from he literature, including 12 smaller than 30 mm. Reviewing the literature the authors selected these studes in which ‘‘authors presented operated osteomas in oronal plane’’. This automatically excludes large case eries, whose authors could not present graphically all the steomas. Three large case series of frontal sinus osteomas were gnored by the authors (total 76 cases).2--4 Two of them resent results of endoscopic surgery.2,4 At least a few ases from these studies should have been included in the nalysis. However, these studies not only do show the examles of coronal CT of giant osteomas, but also present he current state of art of endoscopic surgery of frontal inus osteomas, which was neglected by the authors in the iscussion. Currently frontal sinus osteomas involving the anterior nd posterior frontal sinus wall, penetrating more than 2 cm bove the frontal beak and lateral to the lamina papyracea, nd even these totally filling the sinus (Type IV osteomas) an be safely and effectively removed endoscopically using raf IIb, extended Draf IIb or Draf III approaches.2--4 The imitations of the endoscopic approach are: small anteriorosterior dimension of the frontal ostium, as well as the