[Craniofacial fibrous dysplasia: scan policy or surgery?].
BACKGROUND
The aetiologic correlations of fibrous dysplasia (FD) are more and more decoded by molecular biology, improved imaging procedures, and the use of computer assisted surgery--thus a review of present diagnostics and therapy methods is evaluated.


METHODS
The valid methods of diagnostic and therapy procedures of craniofacial FD were retrospectively analysed in a collective of 9 patients in consideration of literature. The criteria of the decision for diagnosis and surgical procedures were evaluated.


RESULTS
According to the literature, diagnosis was ascertained with modern CT and MRI scans. Bone scintigraphy was only used additionally in particular questions. In case of unclear radiological findings histomorphological procedures were used complementarily to distinguish FD from other bone tumors. The aim of surgical intervention was to reduce pain, to restore the function in compression symptoms, to recover original ostia, or to restore the natural geometry of the face.


CONCLUSIONS
Current imaging procedures allow differential diagnosis from other benign bone tumors but also from malignancies. The therapy of FD is conservative (wait and scan) or operative in dependence on the localisation, the extension and the clinical manifestations of the disease. In the future molecular biological methods could function as supporting instrument for diagnosis if histomorphological results are not meaningful.
Dämmrich
T D
TD
Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde und Poliklinik, Universitätsklinikum Freiburg. Daemmrich@hno.ukl.uni-freiburg.de
Knapp
F B
FB
Boedeker
C C
CC
Klenzner
T
T
Berlis
A
A
Maier
W
W
Schipper
J
J
D000328:Adult; D017076:Computer-Aided Design; D003937:Diagnosis, Differential; D005147:Facial Bones; D005260:Female; D005357:Fibrous Dysplasia of Bone / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000235:genetics / Q000601:surgery; D005500:Follow-Up Studies; D005544:Forecasting; D005624:Frontal Bone; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D019291:Skull Base; D025321:Surgery, Computer-Assisted; D013997:Time Factors; D014057:Tomography, X-Ray Computed