[Pathological changes in face and skull in acromegaly]

31 patients (mean age 52.7 years) suffering from persistent symptoms of a growth hormone producing pituitary adenoma underwent both clinical and roentgenological examinations. The results of standardized x-ray analysis of the viscero- and neurocranium were compared with those of a group of 25 healthy subjects (mean age 42.1 years): Although several remarkable changes were observed, statistically significant changes of the facial skeleton could be found only in the lower jaw. The main contribution to its elongation was given by the chin prominence and the condyle. The findings in the neurocranium could be divided in symptoms of first and symptoms of second choice. With the help of these parameters, a score was established to facilitate interpretation of early signs of acromegaly in lateral skull radiographs. Two clinical symptoms found in our patient sample have not been mentioned before in literature about acromegaly: the so-called "hanging columella" and marked changes in diameter of the canalis mandibularis.