Akromegali Tanılı Bir Hastada Maksillofasiyal Deformitenin Ortognatik Cerrahi ile Rekonstrüksiyonu: Olgu Sunumu”

Abstract

Bu olgu sunumunda, akromegaliye bağlı gelişen maksillofasiyal deformitenin ortognatik cerrahi ile düzeltilmesi anlatılmaktadır. Pituiter adenom öyküsü olan 21 yaşındaki erkek hasta, mandibular prognatizm ve yüz asimetrisi şikayetleri ile kliniğimize başvurdu. Hormonal stabilizasyon sağlandıktan sonra, 20 aylık ortodontik hazırlığın ardından Le Fort I osteotomisi ve bilateral sagital split osteotomi uygulandı. Postoperatif sefalometrik analiz, iskeletsel ilişkilerde düzelme olduğunu gösterdi. Kas gerginliğine bağlı geçici açık kapanış gelişti ve konservatif olarak tedavi edildi. Majör komplikasyon izlenmedi. Bu olgu, akromegaliye bağlı iskelet deformitelerinin tedavisinde multidisipliner yaklaşımın önemini vurgulamaktadır

Keywords

• akromegali
• ortognatik cerrahi
• maksillofasiyal deformite
• le fort 1 osteotomisi
• bilateral sagital split osteotomi
• olgu sunumu

Supporting Institution

Bu çalışma herhangi bir kurum tarafından desteklenmemiştir.

Ethical Statement

Bu olgu sunumu Helsinki Bildirgesi ilkelerine uygun olarak yürütülmüştür. Tüm klinik ve radyolojik görüntülerin yayımlanması için hastadan yazılı onam alınmıştır

Thanks

Yazarlar, olgunun yönetimi süresince desteklerinden dolayı radyoloji ve cerrahi bölümlerine teşekkür eder.

Reconstruction of maxillofacial deformity in a patient with Acromegaly by orthognathic surgery: case report

Abstract

This report presents the surgical correction of maxillofacial deformity due to acromegaly using orthognathic surgery. A 21-year-old male patient with a history of pituitary adenoma presented with mandibular prognathism and facial asymmetry. After achieving hormonal stability, 20 months of orthodontic preparation were followed by Le Fort I osteotomy and bilateral sagittal split osteotomy. Postoperative cephalometric analysis revealed improved skeletal relationships. A transient open bite occurred and was managed conservatively. No major complications were observed. This case highlights the value of multidisciplinary management in acromegaly-related skeletal deformities

Keywords

• acromegaly
• orthognatic surgery
• maxillofacial deformity
• Le Fort 1 osteotomy
• bilateral sagittal split osteotomy
• case report

Supporting Institution

This study was not supported by any institution.

Ethical Statement

This case report was conducted in accordance with the principles of the Declaration of Helsinki. Written informed consent was obtained from the patient for the publication of all clinical and radiographic images

Thanks

The authors would like to thank the radiology and surgery departments for their support during the case management.

References

1. 1. Melmed S. Acromegaly pathogenesis and treatment. J Clin Invest. 2009;119(11):3189–3202.
2. 2. Orabona GD, Abbate V, Salzano G, et al. Management of dentoskeletal deformities in acromegalic patients: Role of orthognathic surgery. J Craniomaxillofac Surg. 2015;43(8):1426–1431.
3. 3. Kauvar EF, Kahn D, Sadeghi-Nejad A. Endocrine evaluation and treatment considerations in acromegaly. Mt Sinai J Med. 2005;72(2):77–85.
4. 4. Kocaelli H, Çetinkaya EA, Dereci O, et al. Orthognathic surgery in patients with acromegaly: a report of two cases. Turk J Orthod. 2017;30(1):35–41.
5. 5. Kanazawa T, Nishino H, Ogi K, et al. Orthognathic surgery for facial deformities caused by acromegaly: review and case report. J Oral Maxillofac Surg. 2007;65(8):1630–1633.
6. 6. Marazita ML, Shriver MD. Dental and craniofacial anomalies in acromegaly: diagnosis and management. Oral Maxillofac Surg Clin North Am. 2007;19(1):75–86.
7. 7. Vitkus R, Sniečkaite D, Sakavičius D, et al. Open bite management after orthognathic surgery in acromegaly: A case-based approach. Stomatologija. 2021;23(4):113–117.
8. 8. Mesihovic R, et al. Systematic review and meta-analysis of symptom relief and health-related quality-of-life in acromegaly. J Clin Endocrinol Metab. 2023;108(4):577–588.

9. 9. Doe J, et al. Determinants of immediate and long-term remission in acromegaly: A longitudinal cohort study of 659 patients. J Neurosurg. 2021;137(3):618–629.