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The psammomatoid ossifying fibroma consisted of numerous cellular fibrous stroma, various bony trabeculae and calcified spherules(psammoma bodies) is known to typically involve the sinonasal tract. It is more destructive than the other benign fibroosseouslesions. Clinical manifestations vary from proptosis, nasal obstruction and headache to cosmetic disfigurement, dependingon the location and the size of lesion. Complete surgical excision is the treatment of choice because of its tendency to recur.The author recently experienced a psammomatoid ossifying fibroma of sinonasal tract in a 37-year-old male with a facial deformityand choanal atresia, had a history of incomplete surgical excision. The choanal atresia was completely removed by endoscopicapproach and the mass in the sinonasal tract was removed by midfacial degloving approach. We report this case withreview of the literature. (Korean J Otolaryngol 2006;49:1212-6)