Paranasal sinus osteoma is a rare benign tumor that evolves slowly and can be responsible for ophthalmologic, sinus and endocranial complications. Its treatment, when it is necessary, is only surgical. We report two cases of fronto-ethmoidal osteoma with orbital extension operated in our department, using a para-latero-nasal approach with supra-superciliary extension. Through these cases and in the light of the literature, we will discuss the interest of this approach in the management of ethmoidal fronto-orbital osteomas. Also, we will underline the advantages and inconveniences of other approaches.