Kraniofaziale Fibröse Dysplasie: Observieren oder Operieren?

Td, Dämmrich; Fb, Knapp; Cc, Boedeker; Klenzner, T.; Berlis, Ansgar; Maier, Wolfgang D.; Schipper, J.

doi:10.1055/s-2006-944766

Cited by 5 publications

(8 citation statements)

References 23 publications

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“…The magnetic resonance imaging (MRI) appearances of FD are often not conclusive for the differential diagnosis of FD. Although CT findings can also be variable, CT more frequently leads to a specific diagnosis thanks to the characteristic ground-glass appearance of woven bone, seen on CT scans in most, if not all, cases of craniofacial FD [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

CT and MR Imaging in a Large Series of Patients with Craniofacial Fibrous Dysplasia

et al. 2015

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SummaryBackgroundIn this retrospective review of patients with craniofacial fibrous dysplasia (FD), the clinical and radiological findings of CT and MR scan were analyzed.Material/MethodsThe study material included 32 patients, at 9 to 68 years of age that were directed for differential diagnostics of several disorders in the head. We recorded CT and MRI data related to the lesion number, location, sidedness, appearance, and sex of the cases with craniofacial FD.ResultsOf 32 patients involved in this study, 17 had monostotic and 15 had polyostotic involvement pattern. Bones most commonly involved by monostotic involvement in females were, in descending order, mandibular, maxillary, and sphenoid bones, while the sphenoid bone was involved the most in males. Leontiasis ossea was observed in 2 patients. Sclerotic and mixed lesion types were more common in both females and males. In T1- and T2-weighted MRI sequences, hypointensity was more common compared to hyperintensity or heterogeneous intensity. The type of enhancement of lesions was found similar after contrast medium administration.ConclusionsIn the presence of craniofacial FD during CT or MRI imaging of the head, a detailed description of FD lesions may provide an important clinical benefit by increasing radiological experience during the diagnostics of this rare disorder.

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Section: Discussionmentioning

confidence: 99%

CT and MR Imaging in a Large Series of Patients with Craniofacial Fibrous Dysplasia

et al. 2015

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“…So konnte im Tierversuch eine calciumphosphatreiche Schicht zwischen Knochen und Bioverit I beobachtet werden, was für eine chemische Bindung spricht [39]. Glaskeramik-Granulat kann intraoperativ in der erforderlichen Menge eingebracht und dann mit Salzlösung gebunden werden und ist somit variabler verwendbar als Platten und Blöcke, die präoperativ zugeschnitten werden müssen [37]; allerdings sind Letztere für präoperativ anhand virtueller Modelle präformierte Implantate geeignet [40,41]. Gegenüber Titan ist die Wärmeleitung deutlich reduziert, und Artefakte in der Bildgebung werden vermieden [40].…”

Section: Titannetzeunclassified

“…Auch im orthopädischen Schrifttum wird eine Osteoneogenese mit konsekutiv besserer Einscheidung und Scherkraftstabilität bei mit Glaskeramik (Bioverit I ) beschichteten Hüftprothesen gegenüber unbeschichteten berichtet [39]. Im Bereich der Schädelbasis bestehen Erfahrungen mit Keramiken insbesondere in der Stirnhöhlenobliteration und -rekonstruktion [37,41], daneben aus der Orbita (siehe Kap. 4.3).…”

Section: Titannetzeunclassified

“…6 und 7 zeigen das Vorgehen bei Planung und Einpassung einer präformierten Glaskeramik anhand einer Patientin mit Fibröser Dysplasie. Werden Keramiken präoperativ geplant und patientenspezifisch präformiert, so gelten hinsichtlich der dafür zu beachtenden Modalitäten hier die gleichen Grundsätze für die präoperative Planungschirurgie, wie sie bereits für Titan ausgeführt wurden [41]. Allerdings haben Glaskeramiken gegenüber Titan den Vorteil, zumindest in geringem Maße bei leichten Abweichungen zwischen geplanter und präfabrizierter Form und intraoperativer Erfordernis bearbeitet werden zu können.…”

Section: Titannetzeunclassified

“…6 Präfabrikation eines Hartgewebsersatzes bei einer Patientin mit frontaler, frontobasaler und ethmoidaler Fibröser Dysplasie. a Links präoperative Planungschirurgie und Modell: die geplanten Resektionszonen entsprechend dem Volumen des zu präformierenden Implantates sind im CT-Datensatz rot markiert (nach Dämmrich et al [41]). b Rechts intraoperative Darstellung der computerassistierten Chirurgie: der Navigationspointer (grün) zeigt auf die Resektionsgrenzen, die in der präoperativen Planungschirurgie festgelegt wurden (orange).…”

Section: Nichtmetallische Implantateunclassified

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Biomaterialien in der Schädelbasischirurgie

Maier¹

2009

Laryngo-Rhino-Otol

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Reconstruction materials and techniques for the skull base have undergone rapid developments and differentiation in recent years. While mostly autotransplants, collagens or resorbable alloplastic materials are preferred for duraplasties, pronounced organ-specific differences can be observed IN the reconstruction of hard tissues. The use of polymethylmethacryl bone cement, once wide-spread, has decreased greatly due to the release of toxic monomers. Bony autotransplants are still used primarily for smaller skull-base defects, intraoperatively formable titanium meshes may be also used for larger fronto- or laterobasal reconstructions of bony defects. Defects in visible areas are increasingly closed with preformed titanium or ceramic implants, which are planned and fitted to the individual patient using preoperative CT imaging. At the skull base, this applies especially to reconstructions of the frontal sinus. For extensive reconstructions of the orbita, titanium meshes and non-resorbable plastics have proven valuable, in closing smaller defects especially of the orbital floor, resorbable implants based on Polyglactin 901 are also used.

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Bisphosphonate treatment in craniofacial fibrous dysplasia—a case report and review of the literature

2008

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Fibrous dysplasia (FD) is a benign skeletal disorder which may affect one or multiple bones. Lesions often involve long bones, ribs, and craniofacial bones and cause pain, fractures, and disfigurement. We describe an adolescent girl with mandibular FD who was successfully treated with bisphosphonates. She presented with a tumor-like lesion of the mandible. During the 2-year follow-up, the lesion expanded and caused significant disfigurement and pain necessitating psychiatric support. Treatment with bisphosphonate administered intravenously resulted in rapid pain relief, normalization of bone turnover, and cosmetic improvement. Management of FD has previously consisted of either conservative follow-up or surgery depending on disease activity and localization. Based on published reports and our experience, bisphosphonates should be considered in the treatment of symptomatic cases. This line of treatment may be suitable especially for craniofacial FD in which surgical treatment is particularly challenging.

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Kraniofaziale Fibröse Dysplasie: Observieren oder Operieren?

Cited by 5 publications

References 23 publications

CT and MR Imaging in a Large Series of Patients with Craniofacial Fibrous Dysplasia

CT and MR Imaging in a Large Series of Patients with Craniofacial Fibrous Dysplasia

Biomaterialien in der Schädelbasischirurgie

Bisphosphonate treatment in craniofacial fibrous dysplasia—a case report and review of the literature

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