Incidental Discovery of Nasal Cavity Osteoma in Severe Chronic Rhinosinusitis with Nasal Polyps

Benign sinonasal osteomas are well-recognized benign sinonasal lesions, but their presence within the nasal cavity is extremely rare. They can result in or be a consequence of chronic inflammatory conditions like rhinosinusitis. The aim of this report is to discuss an incidental discovery of nasal cavity osteoma after a long-standing history of chronic rhinosinusitis with nasal polyps in a 44-year-old male. A computed tomography scan revealed a hyperdense lesion within the right nasal cavity without discrete attachment. Bilateral limited nasal polypectomy and mass removal with twisting motion by forceps, breaking a fragile attachment to the middle turbinate, were performed. The patient reported a dramatic improvement in symptoms, although pansinusitis was left unaddressed. A diagnosis of osteoma was confirmed after a histopathological examination. The patient had no recurrence or active symptoms on follow-up visits. This case underscores the importance of maintaining a high index of suspicion for hidden pathologies, even in established diagnoses, to optimize outcomes through early targeted treatments.