Tokushukai Medical Group

Treatment of disorder

medical treatment

Cranial Nerve Surgery Disease:Fibrous dysplasia

Develop dysosteogenesis come along with fiber proliferation.

Fibrous dysplasia is relatively frequent benignant bone disease, and as its name shown, it is a dysosteogenesis comes with fiber proliferation. It is said that vascular fibrocellular tissue replaces the medullary cavity of bone. This is common among younger generation like 10s to 30s, but it cab be seen on 50s as well. There are two types, the one is solitary type (monostotic) developed at only one location, and the other is multiple type (polyostotic) developed at multiple location, and the most common one is monostotic type. Generally, it is said that proliferation stops when getting matured, but exceptional case is also experienced. The cause is unknown, but it is considered that the G-protein material in intracellular transduction mechanism causes the abnormality, then develops disorder on bone formation.

Many people visit the doctor office when having a pressure symptom of M cranial nerve, but there are quite a lot of patients who are in no symptoms. It distinguished as, takes longer transit course, displacement Paget disease, and ossifying fibroma.

In case of the compression of the optic nerve, it is subject to treatment.

At the diagnosis, glass-like change (ground-glass observation), recognized as bone enlargement by CT, is its character. There is no destruction of the head cortex, and no periosteal reaction is recognized. It is set as important that no edge hardening is seen. In both T1 enhanced image and T2 enhanced image of MRI, enlarged bone indicates low to medium degree signal strength, and in T2 enhanced image, the same to high degree signal is co-exist in low signal. It is contrasted unevenly in Gd, but it commonly shows variety of images so that it is not such easy thing to make diagnosis. In bone scintigraphy, it takes on hot spot so that there is a case which is easy to diagnose and the case which is the killer assignment.

Writer experienced three cases, bone scintigraphy and thallium scintigraphy shows al positive for these three cases, but Ga scintigraphy shows positive in 2 cases but negative for 1 case. In blood vessel photography, 1 case shows pale dyeing image and other 2 cases shows negative. Like, each case shows different observations so that it is vague whether bone scintigraphy and thallium scintigraphy are useful.

In case when optical nerve gets compressed, it becomes the subject to treatment, but in general, transit course is observed. For Fig.1 case, both Ga, Thallium and Bone scintigraphy all are positive, and there is no dyeing image in blood vessel photography.