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Related Experiment Videos

Typical changes in the viscerocranium in acromegaly.

A Künzler1, M Farmand

  • 1Maxillofacial Surgery Clinic, University Hospital Zürich, Switzerland.

Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery
|November 1, 1991
PubMed
Summary
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Persistent growth hormone-producing pituitary adenoma impacts facial structure, particularly the mandible. Post-surgery X-rays reveal significant lower jaw elongation in patients, suggesting specific growth patterns.

Area of Science:

  • Endocrinology
  • Neurosurgery
  • Orthodontics
  • Radiology

Background:

  • Growth hormone-producing pituitary adenomas cause acromegaly, leading to characteristic skeletal overgrowth.
  • Transnasal tumor extirpation is a common treatment, but long-term effects on facial morphology require further investigation.

Purpose of the Study:

  • To evaluate long-term craniofacial changes in patients with growth hormone-producing pituitary adenomas after surgery.
  • To identify specific radiological alterations in the viscerocranium and mandible post-transnasal tumor extirpation.

Main Methods:

  • Clinical and radiological examinations were performed on 31 patients at least one year after tumor removal.
  • Standardized X-ray analysis of the viscerocranium was conducted and compared to a control group of 21 healthy subjects.

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  • Analysis focused on changes in the mandible, including the ascending ramus, body, chin prominence, condyle, and mandibular canal.

    • Main Results:

    • Statistically significant elongation of the lower jaw (mandible) was observed, primarily due to increased length in the chin prominence and condyle.
    • Two distinct mandibular growth patterns were identified, neither exclusively indicative of acromegaly.
    • A 'hanging columella' was noted in 7 patients due to septal cartilage overgrowth.
    • Widening and deviations in the mandibular canal, including a funnel-shaped mandibular foramen, were present in 16 patients.

    Conclusions:

    • Transnasal extirpation of growth hormone-producing pituitary adenomas results in significant long-term mandibular elongation.
    • Facial skeletal changes, particularly in the mandible, persist post-treatment, indicating altered growth dynamics.
    • The observed mandibular canal alterations warrant further investigation regarding potential neurological or dental implications.