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Laryngoscope. 2013 Apr;123(4):823-8. doi: 10.1002/lary.23758. Epub 2013 Feb 26.

Sinonasal disease in polyostotic fibrous dysplasia and McCune-Albright Syndrome.

Author information

1
Department of Otolaryngology-Head and Neck Surgery, Georgetown University Hospital, Washington, DC 20007, USA.

Abstract

OBJECTIVES/HYPOTHESIS:

To characterize the spectrum, symptoms, progression, and effects of endocrine dysfunction on sinonasal disease in polyostotic fibrous dysplasia (PFD) and McCune-Albright Syndrome (MAS).

STUDY DESIGN:

Retrospective review.

METHODS:

A prospectively followed cohort of subjects with PFD/MAS underwent a comprehensive evaluation that included otolaryngologic and endocrine evaluation, and imaging studies. Head and facial computed tomography scans were analyzed, and the degree of fibrous dysplasia (FD) was graded using a modified Lund-MacKay scale. Those followed for >4 years were analyzed for progression.

RESULTS:

A total of 106 patients meeting inclusion criteria were identified with craniofacial FD. A majority (92%) demonstrated sinonasal involvement. There were significant positive correlations between the sinonasal FD scale score and chronic congestion, hyposmia, growth hormone excess, and hyperthyroidism (P < .05 for all). Significant correlations were not found for headache/facial pain or recurrent/chronic sinusitis. Thirty-one subjects met the criteria for longitudinal analysis (follow-up mean, 6.3 years; range, 4.4-9 years). Those who demonstrated disease progression were significantly younger than those who did not (mean age, 11 vs. 25 years). Progression after age of 13 years was uncommon (n = 3) and minimal. Concomitant endocrinopathy or bisphosphonate use did not have any significant effect on progression of disease.

CONCLUSIONS:

Sinonasal involvement of fibrous dysplasia in PFD/MAS is common. Symptoms are usually few and mild, and disease progression occurs primarily in young subjects. Concomitant endocrinopathy is associated with disease severity, but not progression.

PMID:
23444264
PMCID:
PMC3609909
DOI:
10.1002/lary.23758
[Indexed for MEDLINE]
Free PMC Article
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