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Mohammed S, Jang SH, Moon IS. Fibrous Dysplasia of Temporal Bone. Indian J Otolaryngol Head Neck Surg 2022; 74:4350-4355. [PMID: 36742801 PMCID: PMC9895677 DOI: 10.1007/s12070-021-03009-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/21/2021] [Indexed: 02/07/2023] Open
Abstract
Fibrous dysplasia of temporal bone is a rare benign bone disease. With the advance in imaging, more cases are likely to get reported and present with less disease severity. Temporal Bone Fibrous dysplasia most commonly affects External Auditory canal resulting in External auditory canal stenosis and Conductive Hearing Loss. Many patients are asymptomatic and rarely require intervention. However, we present 3 different clinical scenarios of Temporal Bone Fibrous Dysplasia and elaborate on clinical course that lead to varied managements for each of them.
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Affiliation(s)
- Safeer Mohammed
- Department of Otorhinolaryngology, Amrita Institute of Medical Sciences, Kochi, India
| | - Seung Hyun Jang
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
| | - In Seok Moon
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
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Oliver JD, Jia S, Halpern LR, Graham EM, Turner EC, Colombo JS, Grainger DW, D'Souza RN. Innovative Molecular and Cellular Therapeutics in Cleft Palate Tissue Engineering. TISSUE ENGINEERING PART B-REVIEWS 2020; 27:215-237. [PMID: 32873216 DOI: 10.1089/ten.teb.2020.0181] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Clefts of the lip and/or palate are the most prevalent orofacial birth defects occurring in about 1:700 live human births worldwide. Early postnatal surgical interventions are extensive and staged to bring about optimal growth and fusion of palatal shelves. Severe cleft defects pose a challenge to correct with surgery alone, resulting in complications and sequelae requiring life-long, multidisciplinary care. Advances made in materials science innovation, including scaffold-based delivery systems for precision tissue engineering, now offer new avenues for stimulating bone formation at the site of surgical correction for palatal clefts. In this study, we review the present scientific literature on key developmental events that can go awry in palate development and the common surgical practices and challenges faced in correcting cleft defects. How key osteoinductive pathways implicated in palatogenesis inform the design and optimization of constructs for cleft palate correction is discussed within the context of translation to humans. Finally, we highlight new osteogenic agents and innovative delivery systems with the potential to be adopted in engineering-based therapeutic approaches for the correction of palatal defects. Impact statement Tissue-engineered scaffolds supplemented with osteogenic growth factors have attractive, largely unexplored possibilities to modulate molecular signaling networks relevant to driving palatogenesis in the context of congenital anomalies (e.g., cleft palate). Constructs that address this need may obviate current use of autologous bone grafts, thereby avoiding donor-site morbidity and other regenerative challenges in patients afflicted with palatal clefts. Combinations of biomaterials and drug delivery of diverse regenerative cues and biologics are currently transforming strategies exploited by engineers, scientists, and clinicians for palatal cleft repair.
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Affiliation(s)
- Jeremie D Oliver
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA.,Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA
| | - Shihai Jia
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Leslie R Halpern
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Emily M Graham
- School of Medicine, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Emma C Turner
- University of Western Australia Dental School, Perth, Western Australia
| | - John S Colombo
- University of Las Vegas at Nevada School of Dental Medicine, Las Vegas, Nevada, USA
| | - David W Grainger
- Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA.,Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Rena N D'Souza
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA.,Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA.,School of Medicine, University of Utah Health Sciences, Salt Lake City, Utah, USA
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Tripathy SK, Swaroop S, Velagada S, Priyadarshini D, Das RR, Satpathy AK, Agrawal K. Response to Zoledronic Acid Infusion in Children With Fibrous Dysplasia. Front Pediatr 2020; 8:582316. [PMID: 33330278 PMCID: PMC7732464 DOI: 10.3389/fped.2020.582316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 10/02/2020] [Indexed: 02/05/2023] Open
Abstract
Objective: This retrospective study evaluated the outcome and safety of long-term treatment with zoledronic acid, in both polyostotic and mono-ostotic fibrous dysplasia (FD) of children. Methods: The case records of children and adolescents with symptomatic FD who received zoledronic acid (0.1 mg/kg IV infusion over 1 h) and have completed at least 2 years follow-up were analyzed. The relevant details were recorded in a predesigned chart. Clinical assessment [pain assessment by visual analog scale (VAS) and incidence of new fracture], radiological changes (cortical thickening, ossification, and decrease in the diameter of the osteolytic lesions) and biochemical parameters [alkaline phosphatase (ALP)] were used to evaluate the improvement. Results: The mean age of presentation was 9.1 years, with four males and six females. All patients had symptomatic FD in the lower limb with complaints of pain, tenderness, swelling, or deformity. Four children had associated pathological fracture. The radiological evaluation with bone scan revealed polyostotic involvement in eight patients and mono-ostotic involvement in two patients. Three patients had associated systemic features like café-au-lait spots or precocious puberty. The fracture united within 3 months and the radiological improvement was evident in the form of filling of the osteolytic defect. The pain score in six patients showed significant improvement (VAS < 3). The ALP level decreased to 544.12 ± 47.35 IU/L from an initial value of 895.75 ± 79.64 IU/L (p = 0.04) at 12 months. One patient had symptomatic hypocalcaemia after zoledronic acid infusion. Conclusion: The clinical and radiological response of zoledronic acid treatment in FD of children is promising. Further randomized control trials with a larger sample size are required to establish this drug as a first-line medical treatment in FD.
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Rotman M, Hamdy NAT, Appelman-Dijkstra NM. Clinical and translational pharmacological aspects of the management of fibrous dysplasia of bone. Br J Clin Pharmacol 2018; 85:1169-1179. [PMID: 30471134 PMCID: PMC6533424 DOI: 10.1111/bcp.13820] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 11/08/2018] [Accepted: 11/10/2018] [Indexed: 12/11/2022] Open
Abstract
Fibrous dysplasia (FD) is a genetic, noninheritable rare bone disease caused by a postzygotic activating mutation of the α subunit of the stimulatory G‐protein causing increased abnormal bone formation leading to pain, deformity and fractures. To date, no cure has been identified for FD/McCune–Albright syndrome (MAS) and treatment is symptomatic and aimed at decreasing pain and/or local bone turnover. Various drugs have been used to achieve clinical improvement in FD/MAS patients including bisphosphonates and denosumab, however further translational studies are also warranted to address unresolved pathophysiological issues and explore novel pharmacological targets for the management of FD/MAS. In this article, we review literature on the medical treatment of FD/MAS, discuss the unresolved pathophysiological issues and explore novel pharmacological targets for the management of FD/MAS.
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Affiliation(s)
- Marlous Rotman
- Department of Medicine, Division of Endocrinology & Centre for Bone Quality, Leiden University Medical Center, Leiden, the Netherlands
| | - Neveen Agnes Therese Hamdy
- Department of Medicine, Division of Endocrinology & Centre for Bone Quality, Leiden University Medical Center, Leiden, the Netherlands
| | - Natasha M Appelman-Dijkstra
- Department of Medicine, Division of Endocrinology & Centre for Bone Quality, Leiden University Medical Center, Leiden, the Netherlands
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Mierzwiński J, Kosowska J, Tyra J, Haber K, Drela M, Paczkowski D, Burduk P. Different clinical presentation and management of temporal bone fibrous dysplasia in children. World J Surg Oncol 2018; 16:5. [PMID: 29335001 PMCID: PMC5769533 DOI: 10.1186/s12957-017-1302-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 12/18/2017] [Indexed: 12/29/2022] Open
Abstract
Background Fibrous dysplasia is a slowly progressive benign fibro-osseous disorder that involves one or multiple bones with a unilateral distribution in most cases. It is a lesion of unknown etiology, uncertain pathogenesis, and diverse histopathology. Temporal bone involvement is the least frequently reported type, especially in children. We reviewed available articles regarding fibrous dysplasia with temporal bone involvement in children and added four patients aged 7 to 17 years who were diagnosed and treated in our institution from 2006 to 2017. The patients’ clinical picture comprised head deformity, external canal stenosis, headache, progressive conductive and/or sensorineural hearing loss, tinnitus, and sudden deafness. Two patients had experienced severe episodic vertigo with nausea and vomiting. Two were referred to us with external canal obstruction and secondary cholesteatoma formation with broad middle ear destruction. One was diagnosed with acute mastoiditis and intracranial complications. Optimal management of fibrous dysplasia is unclear and can be challenging, especially in children. In our two patients with disease expansion and involvement of important structures, surgical treatment was abandoned and a “wait-and-scan” policy was applied. The other two were qualified for surgical treatment. One patient underwent two surgeries: modified lateral petrosectomy (canal left open) with pathological tissue removal, cavity obliteration, and subsequent tympanoplasty. Another patient with extensive destruction of the left temporal bone underwent canal wall down mastoidectomy with perisinus abscess drainage and revision 12 months later. Tympanoplasty was unsatisfactory in both patients because of slow progression of the middle ear pathology. None of our patients underwent pharmacological treatment. Conclusions In younger patients, observation and a “wait-and-scan” protocol is relevant until significant function, or cosmetic deficits are obvious. Surgery is not preferred and should be delayed until puberty because fibrous dysplasia has a tendency to stabilize after adolescence. In patients with severe symptoms medical treatment can be implemented, but safety of this treatment in children remain controversial.
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Affiliation(s)
- Józef Mierzwiński
- Department of Otolaryngology, Audiology and Phoniatrics, Children's Hospital of Bydgoszcz, Chodkiewicza 44, 85-667, Bydgoszcz, Poland.
| | - Justyna Kosowska
- Department of Otolaryngology, Audiology and Phoniatrics, Children's Hospital of Bydgoszcz, Chodkiewicza 44, 85-667, Bydgoszcz, Poland
| | - Justyna Tyra
- Department of Otolaryngology, Audiology and Phoniatrics, Children's Hospital of Bydgoszcz, Chodkiewicza 44, 85-667, Bydgoszcz, Poland
| | - Karolina Haber
- Department of Otolaryngology, Audiology and Phoniatrics, Children's Hospital of Bydgoszcz, Chodkiewicza 44, 85-667, Bydgoszcz, Poland
| | - Maria Drela
- Department of Otolaryngology, Audiology and Phoniatrics, Children's Hospital of Bydgoszcz, Chodkiewicza 44, 85-667, Bydgoszcz, Poland
| | - Dariusz Paczkowski
- Department of Pediatric Neurosurgery, Children's Hospital of Bydgoszcz, Chodkiewicza 44, 85-667, Bydgoszcz, Poland
| | - Paweł Burduk
- Department of Otolaryngology and Laryngological Oncology Faculty of Medicine, Collegium Medicum Nicolaus Copernicus University, Bydgoszcz, Poland
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Bowden SA, Mahan JD. Zoledronic acid in pediatric metabolic bone disorders. Transl Pediatr 2017; 6:256-268. [PMID: 29184807 PMCID: PMC5682380 DOI: 10.21037/tp.2017.09.10] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Accepted: 09/19/2017] [Indexed: 01/06/2023] Open
Abstract
Zoledronic acid (ZA), a highly potent intravenous bisphosphonate (BP), has been increasingly used in children with primary and secondary osteoporosis due to its convenience of shorter infusion time and less frequent dosing compared to pamidronate. Many studies have also demonstrated beneficial effects of ZA in other conditions such as hypercalcemia of malignancy, fibrous dysplasia (FD), chemotherapy-related osteonecrosis (ON) and metastatic bone disease. This review summarizes pharmacologic properties, mechanism of action, dosing regimen, and therapeutic outcomes of ZA in a variety of metabolic bone disorders in children. Several potential novel uses of ZA are also discussed. Safety concerns and adverse effects are also highlighted.
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Affiliation(s)
- Sasigarn A. Bowden
- Division of Endocrinology, Department of Pediatrics, Nationwide Children’s Hospital/the Ohio State University College of Medicine, Columbus, Ohio, USA
| | - John D. Mahan
- Division of Nephrology, Department of Pediatrics, Nationwide Children’s Hospital/the Ohio State University College of Medicine, Columbus, Ohio, USA
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