Management of craniofacial osteitis deformans

Paget's disease of bone (PDB) is a progressive chronic disease of unknown etiology, manifested as initial increase in bone resorption, followed by a disorganized and excessive formation of bone, resulting in pain and skeletal deformities. Treatment of the disease primarily aims at reducing the altered bone turnover by pharmacotherapy, along with surgical intervention for deformed bones, to reduce morbidity and improve the quality of living. We present a case of PDB with craniofacial involvement in a 55-year-old female, diagnosed on the basis of clinical features, radiological assessment along with biochemical findings and histopathological report. Our management included medical treatment in the form of intravenous bisphosphonates which alleviated symptoms by reducing the abnormal bone activity, and normalized serum alkaline phosphatase. Patient morale, self-confidence and social acceptance were all boosted due to the surgical correction of the facial deformity.