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Eckstein A, Welkoborsky HJ. [Interdisciplinary Management of Orbital Diseases]. Laryngorhinootologie 2024; 103:S43-S99. [PMID: 38697143 DOI: 10.1055/a-2216-8879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
Diagnosis and therapy of orbital diseases is an interdisciplinary challenge, in which i.e. otorhinolaryngologists, ophthalmologists, radiologists, radiation therapists, maxillo-facial surgeons, endocrinologists, and pediatricians are involved. This review article describes frequent diseases which both, otolaryngologists and ophthalmologists are concerned with in interdisciplinary settings. In particular the inflammatory diseases of the orbit including orbital complications, autoimmunological diseases of the orbit including Grave´s orbitopathy, and primary and secondary tumors of the orbit are discussed. Beside describing the clinical characteristics and diagnostic steps the article focusses on the interdisciplinary therapy. The review is completed by the presentation of most important surgical approaches to the orbit, their indications and possible complications. The authors tried to highlight the relevant facts despite the shortness of the text.
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Affiliation(s)
| | - H-J Welkoborsky
- Univ. Klinik für Augenheilkunde Universitätsmedizin Essen, Klinik für HNO-Heilkunde, Kopf- und Halschirurgie, Klinikum Nordstadt der KRH
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Traversari M, Serrangeli MC, Catalano G, Petrella E, Piciucchi S, Feletti F, Oxilia G, Cristiani E, Vazzana A, Sorrentino R, De Fanti S, Luiselli D, Calcagnile L, Saragoni L, Feeney RNM, Gruppioni G, Cilli E, Benazzi S. Multi-analytic study of a probable case of fibrous dysplasia (FD) from certosa monumental cemetery (Bologna, Italy). INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2019; 25:1-8. [PMID: 30913508 DOI: 10.1016/j.ijpp.2019.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 03/08/2019] [Accepted: 03/08/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To evaluate, via a multidisciplinary approach, a distinctive paleopathological condition believed to be fibrous dysplasia, found on a 19th/20th century skeleton from Certosa Monumental Cemetery, Bologna, Italy. MATERIALS A skeletonized cranium and mandible recovered from an ossuary in 2014. METHODS Pathological alterations were analysed by radiological examination, dental macrowear, histopathological and genetic analyses. RESULT The skeleton is believed to be an adult male. Differential diagnoses include Paget's disease, McCune-Albright syndrome, osteochondroma and osteosarcoma. The radiographic findings, along with the solitary nature of the lesions, are strong evidence for the diagnosis of fibrous dysplasia (FD). Genetic analysis further revealed a frequency of ˜1% of mutant alleles with the R201C substitution, one of the post-zygotic activating mutation frequently associated with FD. CONCLUSIONS The multi-analytical method employed suggests a diagnosis of monostotic form of FD. The diagnostic design incorporates multiple lines of evidence, including macroscopic, histopathological, and genetic analyses. SIGNIFICANCE Through the use of a multi-analytic approach, robust diagnoses can be offered. This case serves as one of the oldest examples of FD from an historical context. The genetic mutation detected, associated with FD, has not been previously reported in historical/ancient samples.
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Affiliation(s)
- Mirko Traversari
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy.
| | - Maria Cristina Serrangeli
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy; UCD School of Medicine, Health Science Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - Giulio Catalano
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy
| | - Enrico Petrella
- Department of Radiology, AUSL Romagna, Morgagni-Pierantoni city hospital, via Carlo Forlanini 34, 47121, Forlì, Italy
| | - Sara Piciucchi
- Department of Radiology, AUSL Romagna, Morgagni-Pierantoni city hospital, via Carlo Forlanini 34, 47121, Forlì, Italy
| | - Francesco Feletti
- Department of Diagnostic Imaging Ausl Romagna, Santa Maria delle Croci Hospital, Viale Randi, 5, 48121 Ravenna, Italy
| | - Gregorio Oxilia
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy
| | - Emanuela Cristiani
- Department of Oral and Maxillofacial Sciences, School of Dentistry, Sapienza University of Rome, Via Caserta, 6, 00161 Rome
| | - Antonino Vazzana
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy
| | - Rita Sorrentino
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy; Department of Biological, Geological and Environmental Sciences, University of Bologna, via Selmi 3, Bologna, Italy
| | - Sara De Fanti
- Department of Biological, Geological and Environmental Sciences, University of Bologna, via Selmi 3, Bologna, Italy
| | - Donata Luiselli
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy
| | - Lucio Calcagnile
- CEDAD - CEnter for DAting and Diagnostics Department of Mathematics and Physics "Ennio De Giorgi", University of Salento and INFN-National Institute for Nuclear Physics, Via Monteroni, 73100, Lecce, Italy
| | - Luca Saragoni
- Department of Pathological Anatomy, AUSL Romagna, Morgagni-Pierantoni city hospital, via Carlo Forlanini 34, 47121, Forlì, Italy
| | - Robin N M Feeney
- UCD School of Medicine, Health Science Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - Giorgio Gruppioni
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy
| | - Elisabetta Cilli
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy
| | - Stefano Benazzi
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy; Department of Human Evolution, Max Planck Institute for Evolutionary Anthropology, Deutscher Platz 6, 04103, Leipzig, Germany
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Andreu-Arasa VC, Chapman MN, Kuno H, Fujita A, Sakai O. Craniofacial Manifestations of Systemic Disorders: CT and MR Imaging Findings and Imaging Approach. Radiographics 2018; 38:890-911. [PMID: 29624481 DOI: 10.1148/rg.2018170145] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Many systemic diseases or conditions can affect the maxillofacial bones; however, they are often overlooked or incidentally found at routine brain or head and neck imaging performed for other reasons. Early identification of some conditions may significantly affect patient care and alter outcomes. Early recognition of nonneoplastic hematologic disorders, such as thalassemia and sickle cell disease, may help initiate earlier treatment and prevent serious complications. The management of neoplastic diseases such as lymphoma, leukemia, or Langerhans cell histiocytosis may be different if diagnosed early, and metastases to the maxillofacial bones may be the first manifestation of an otherwise occult neoplasm. Endocrinologic and metabolic disorders also may manifest with maxillofacial conditions. Earlier recognition of osteoporosis may alter treatment and prevent complications such as insufficiency fractures, and identification of acromegaly may lead to surgical treatment if there is an underlying growth hormone-producing adenoma. Bone dysplasias sometimes are associated with skull base foraminal narrowing and subsequent involvement of the cranial nerves. Inflammatory processes such as rheumatoid arthritis and sarcoidosis may affect the maxillofacial bones, skull base, and temporomandibular joints. Radiologists should be familiar with the maxillofacial computed tomographic and magnetic resonance imaging findings of common systemic disorders because these may be the first manifestations of an otherwise unrevealed systemic process with potential for serious complications. Online supplemental material is available for this article. ©RSNA, 2018.
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Affiliation(s)
- V Carlota Andreu-Arasa
- From the Departments of Radiology (V.C.A.A., M.N.C., H.K., A.F., O.S.), Otolaryngology-Head and Neck Surgery (O.S.), and Radiation Oncology (O.S.), Boston University Medical Center, Boston University School of Medicine, 820 Harrison Ave, 3rd Floor, Boston, MA 02118
| | - Margaret N Chapman
- From the Departments of Radiology (V.C.A.A., M.N.C., H.K., A.F., O.S.), Otolaryngology-Head and Neck Surgery (O.S.), and Radiation Oncology (O.S.), Boston University Medical Center, Boston University School of Medicine, 820 Harrison Ave, 3rd Floor, Boston, MA 02118
| | - Hirofumi Kuno
- From the Departments of Radiology (V.C.A.A., M.N.C., H.K., A.F., O.S.), Otolaryngology-Head and Neck Surgery (O.S.), and Radiation Oncology (O.S.), Boston University Medical Center, Boston University School of Medicine, 820 Harrison Ave, 3rd Floor, Boston, MA 02118
| | - Akifumi Fujita
- From the Departments of Radiology (V.C.A.A., M.N.C., H.K., A.F., O.S.), Otolaryngology-Head and Neck Surgery (O.S.), and Radiation Oncology (O.S.), Boston University Medical Center, Boston University School of Medicine, 820 Harrison Ave, 3rd Floor, Boston, MA 02118
| | - Osamu Sakai
- From the Departments of Radiology (V.C.A.A., M.N.C., H.K., A.F., O.S.), Otolaryngology-Head and Neck Surgery (O.S.), and Radiation Oncology (O.S.), Boston University Medical Center, Boston University School of Medicine, 820 Harrison Ave, 3rd Floor, Boston, MA 02118
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Guatta R, Scolozzi P. Bone Recontouring by Guided Surgical Navigation Integrating “Mirroring” Computational Planning in the Management of Severe Fronto-orbital Asymmetry in Fibrous Dysplasia. J Neurol Surg A Cent Eur Neurosurg 2018; 79:181-185. [DOI: 10.1055/s-0037-1615286] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AbstractWe report the successful treatment of severe fronto-orbital asymmetry in a 20-year-old man with fibrous dysplasia by bone recontouring using a specific approach combining “mirroring” virtual computational planning with intraoperative guided surgical navigation.
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Affiliation(s)
- Ramona Guatta
- Department of Clinical Neurosciences, Neurosurgery, University Hospitals of Geneva, Geneva, Switzerland
| | - Paolo Scolozzi
- Division of Oral and Maxillofacial Surgery, Department of Surgery, University Hospitals of Geneva, Geneva, Switzerland
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Zhang L, He Q, Li W, Zhang R. The value of 99mTc-methylene diphosphonate single photon emission computed tomography/computed tomography in diagnosis of fibrous dysplasia. BMC Med Imaging 2017; 17:46. [PMID: 28738834 PMCID: PMC5525212 DOI: 10.1186/s12880-017-0218-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 07/17/2017] [Indexed: 11/10/2022] Open
Abstract
Background Fibrous dysplasia (FD) is a rare benign bone disorder in which the normal bone is replaced by immature fibro-osseous tissue. However, some case reports have reported that FD showed significantly increased 99mTc-methylene diphosphonate (99mTc-MDP) uptake on whole-body bone scintigraphy (WBS), which may mimic bone metastasis or skeletal involvement of the patients with known cancer. Thus, the purpose of present study is to observe the reliable characteristics and usefulness of single photon emission computed tomography/computed tomography (SPECT/CT) for the diagnosis of FD. Methods This was a retrospective review of 21 patients with FD (14 males and 7 females, mean age 51.2 ± 12.5 years) who were referred to have WBS to determine whether there was any osseous metastasis. WBS and SPECT/CT images were independently interpreted by two experienced nuclear medicine physician together with a diagnostic radiologist. In cases of discrepancy, consensus was obtained by a joint reading. The final diagnosis was based on biopsy proof and radiologic follow-up over at least 1 year. Results The lesions of FD were most frequently found in craniofacial region (15/21). Eighteen of the 21 (85.7%) cases showed moderate and high metabolism on WBS (compared to sternum). On CT imaging, GGO and expansion were the most common finding, were noted in 90.5% and 85.7% of the patients. Lytic lesions were present in 61.9% of the patients, and sclerosis was present in 38.1% of the patients. Cortical disruption was not seen in any patient. Conclusions FD has certain characteristic appearance on SPECT/CT. It should be enrolled in the differential diagnoses when lesions show elevated 99mTc-MDP uptake on WBS. For SPECT/CT, the CT features of GGO and expansion in the areas of abnormal radiotracer uptake are helpful for the diagnosis of FD.
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Affiliation(s)
- Linqi Zhang
- Department of Nuclear Medicine, Affiliated Cancer Hospital&Institute of Guangzhou Medical University, 78 Hengzhigang Road, Guangzhou, 510095, Guangdong province, People's Republic of China
| | - Qiao He
- Department of Nuclear Medicine, the First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan Er Road, Guangzhou, 510080, Guangdong province, People's Republic of China
| | - Wei Li
- Department of Nuclear Medicine, Affiliated Cancer Hospital&Institute of Guangzhou Medical University, 78 Hengzhigang Road, Guangzhou, 510095, Guangdong province, People's Republic of China
| | - Rusen Zhang
- Department of Nuclear Medicine, Affiliated Cancer Hospital&Institute of Guangzhou Medical University, 78 Hengzhigang Road, Guangzhou, 510095, Guangdong province, People's Republic of China.
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