Clinical features of fibrous dysplasia and ossifying fibroma are aspecific and determined by a submucosal slow expansion. A diagnostic delay of up to 10 years has been reported for ossifying fibroma (Boysen et al. 1979).
Even though painless facial and skull deformities are the most frequently observed signs, symptoms such as nasal obstruction, headache, epistaxis, anosmia, loosening of teeth, facial paralysis, hearing loss, trigeminal neuralgia-like pain, and recurrent rhinosinusitis due to drainage impairment may develop (Bollen et al. 1990; Camilleri 1991; Ferguson 1994; Slootweg et al. 1994; Wenig et al. 1995; Redaelli De Zinis et al. 1996; Chong and Tang 1997; Commins et al. 1998; Muraoka et al. 2001; Cheng et al. 2002). Diplopia, proptosis, loss of visual acuity due to optic nerve compression, epiphora, limitation of ocular motility are other important symptoms and signs indicating an involvement of the orbit and/or of the lacrymal pathways (Moore et al. 1985; Osguthorpe and Gudeman 1987; Johnson et al. 1991; Slootweg et al. 1994; Wenig et al. 1995; Redaelli De Zinis et al. 1996). Since both diseases display a submucosal pattern of growth, nasal endoscopy is often negative or shows a lesion covered by intact mucosa.
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