Displasia fibrosa do osso temporal: relato de dois casos

Abstract

A displasia fibrosa do osso temporal é uma doença de etiologia ainda controversa, manifestando-se principalmente por estenose progressiva do conduto auditivo externo e pela perda condutiva da audição. Outras manifestações incluem abaulamento na região temporal ou retroauricular, otorréia, otalgia e disacusia sensório-neural. A incidência é maior no sexo masculino e acomete principalmente a raça branca. O exame radiológico característico demonstra um aspecto de "vidro-fosco" homogêneo envolvido por uma concha de tecido cortical denso, embora existam outros padrões radiológi-cos desta enfermidade. O exame microscópico demonstra um trabeculado ósseo semelhante aos caracteres chineses. Este estudo relata dois casos de displasia fibrosa do osso temporal que se destacam, pois ultrapassaram o osso temporal, acometendo a região zigomática, sendo que no segundo caso houve também comprometimento do osso esfenóide e o pterigóide. Os pacientes foram submetidos à mastoidectomia radical modificada e tiveram boa evolução. Fi brous dysplasia of the temporal bone (FDTB) is a disorder which etiology is still controversial. Its main clinical feature is a progressive narrowing of the external auditory canal following by conductive hearing loss. Temporal or retroauricular enlargement, ear discharge, otalgia, and sensorineural hearing loss are additional findings. Women and Caucasians are more affected. The prominent finding is a homogeneous radiodense "grounded glass" like image shell surrounded by dense cortical tissue. However, other radiological patterns of this disease may be displayed. Microscopically, a trabecular of bone in "Chinese letter" configuration is found. The two cases of FDTB herein reported are particularly special for a far beyond temporal commitment reaching the zygomatic area in the first case and sphenoid and pterygoid bones in the second one. This infrequent clinical feature with unusual radiological findings made these two cases worth-reported. Rev Bras Otorrinolaringol. V.70, n.5, 695-700, set./out. 2004 Palavras-chave: displasia fibrosa, osso temporal, mastoidectomia. Roberto CASE REPORT RELATO DE CASO

Fibrous Dysplasia in Maxillary Bone: Case Report

“…The follow-up is of fundamental importance (time) in order to detect relapses or a possible, malignant change at an early stage. [25]. In the case reported, tomographic images of the lesion assumed a hyperdense pattern interspersed with hypodense areas of imprecise limits, resulting in the classic aspect of "ground glass".…”

“…complex right side, sphenoid, as well as region of nasal cavity.Initially the disease is asymptomatic. The signs and symptoms in FD are dependent on the location of the lesion(s) and the compressive effect on neighboring structures as the tumour progresses slowly: Asymmetry and facial deformity; Pathological fractures; Obstruction of the paranasal sinuses generating recurrent infections, cysts and mucoceles; Anosmia, headache, loss of visual acuity by compression of the optic nerve; Alteration of ocular movements, ptosis, exophthalmos, strabismus; Conductive hearing loss[18,[23][24][25].…”

Case Report of Fibrous Dysplasia of Maxillary Region

“…The microscopic evaluation shows a collagen matrix stroma with fibroblasts in a entangled standard with osseous trabeculate similar to the "Chinese writing" (12).The FD differential diagnosis includes malignant (sarcoma, metastatic osteoblastic lesions) and benign lesions (ossifying fibroma, Paget's disease, aneurismatic osseous cyst, cystic Cristeller Syndrome, ameloblastoma, osteochondroma, hyperthyroidism etc.) (1,6,8,10,12). The main factors that guide the FD approach are the presence and the intensity of the symptoms, the tumor location and the patient's age.…”

“…The FD signals and symptoms depend on the location of the lesion(s) and the compressive effect in the adjacent structure as the tumor progresses slowly: facial asymmetry and deformity; pathological fractures; obstruction of the paranasal sinuses which generate recurrence infections, cysts and mucoceles; anosmia; headache; loss of visual accuracy for compression of the optic nerve; alteration of the ocular movements; descent; exophthalmia, squint; conductive hearing loss (4, 9, 11, 12).The CT is the choice exam for the study of the lesion(s), analysis of their extension and surgical preparation (6,11). Basically, three radiographic standards in the cranium fibrous dysplasia and facial bones are described: pategoid, that alternates the radiodense and radiotransparent areas; sclerotic, homogeneously dense; cystic standard, with spherical or ovoid radiolucid area surrounded by dense limits (12). In the case reported, the lesion tomographic images presented a hyperdense standard intermixed by imprecise limits hypodense areas, which resulted in the classical aspect of "opaque glass".…”

Craniofacial Fibrous Dysplasia Addressed Through The Intraoral And Nasal Access

“…Injuries such as sarcoma and metastatic osteoblastic lesions are considered malignant lesions of diagnosis. Observed an occurrence of 0.4% of spontaneous neoplastic transformation to sarcoma [15,16].…”