Hiperostozis Frontalis Interna ve Klinik Önemi

Öz

Amaç: Frontal kemikteki heterotopik ossifikasyonun metabolik, endokrinolojik, nörolojik ve psikolojik nedenleri giderek önem kazanmaktadır. Hiperostozis frontalis interna (HFI) adı verilen ön kemiğin aşırı büyümesi baş ağrısına ve nadiren nöbetlere neden olabilir. HFI kadınlarda dokuz kat daha sık görülür ve virilizasyon, obezite ve nöropsikiyatrik problemlerle ortaya çıktığında Morgagni-Stewart-Morel sendromu olarak adlandırılır. Uzun süreli östrojen maruziyeti, ileri yaş, kadın cinsiyet, testosteron baskılanmasının ortadan kalkması, erkek tipi hipogonadizm, genetik, çevresel faktörler, obezite, diyet, Diabetes Mellitus, bazı metabolik hastalıklar, otoimmünite (ANA+), endokrin dengesizliği ve LEPTIN HFI'ye neden olur. HFI hastalarının yaklaşık %20'sinde baş ağrısı, obezite, vertigo/baş dönmesi, bilişsel gerileme ve depresyon görülür. Yöntem: Çalışmamız ABD'nin New -York Albert Einstein College of Medicine Anatomi Laboratuvarında 2016-2019 yılları arasında dört yıl boyunca gerçekleştirildi. Heterotopik ossifikasyonu değerlendirmek için bölümden alınan formalinle sabitlenmiş kadavralardan yararlandık. HFI+ sergileyen kadavralar özellikle tanındı. Olguların cinsiyeti ve yaşı dikkate alındı. Yaşları 42 ila 103 arasında değişen 74 donör değerlendirildi. Bulgular: Çalışma, HFI sıklığının %41,89 olduğunu, toplumdaki erkeklerde görülme sıklığının ise %9,45 olduğunu göstermektedir. Bu, tüm HFI vakalarının %22,58'ini temsil etmektedir. Kadınlar arasındaki insidans, popülasyonda %32,43 olarak kaydedilmiş olup, toplam HFI vakalarının %77,42'sini temsil etmektedir. Sonuç: Bulgular, HFI araştırması ve etiyolojisinde östrojen maruziyetinin diğer faktörlerle birlikte dikkate alınması gerektiğini göstermektedir. Genetik veya epigenetik faktörler bazı kliniklerde daha sık görülen HFI'yi tetikleyebilir. Bu korelasyonu doğrulamak için daha büyük bir popülasyon çalışmasına ihtiyaç vardır

Anahtar Kelimeler

• Hiperostozis frontalis interna
• Akromegali
• Postmenopozal kadın
• Calvarial büyüme
• Heterotopik ossifikasyon

Hyperostosis Frontalis Interna and Its Clinical Significance

Öz

Objective: The metabolic, endocrinological, neurological, and psychological causes of heterotopic ossification in frontal bone have become increasingly important. Overgrowth of the frontal bone, called hyperostosis frontalis interna (HFI), can cause headaches and, rarely, seizures. HFI is nine times more common in women and is called Morgagni-Stewart-Morel syndrome when it occurs with virilization, obesity, and neuropsychiatric problems. Long-term estrogen exposure, advanced age, female gender, testosterone suppression removal, male-type hypogonadism, genetics, environmental factors, obesity, diet, Diabetes mellitus, some metabolic diseases, autoimmunity (ANA+), endocrine imbalance, and LEPTIN cause HFI. About 20% of HFI patients experience headaches, obesity, vertigo/dizziness, cognitive decline, and depression. Methods: Our study was conducted over four years, from 2016 to 2019, at the Anatomy Department of Albert Einstein College of Medicine in New York, USA. We utilized formalin- fixed course cadavers from the department to assess heterotopic ossification. The cadavers exhibiting HFI+ were particularly recognized. The gender and age of the cases were considered. 74 donors, ranging in age from 42 to 103, were assessed. Results: The study indicates that the frequency of HFI is 41.89%, with a prevalence of 9.45% among men in the population. This represents 22.58% of all HFI cases. The incidence among women is recorded at 32.43% within the population, representing 77.42% of total HFI cases. Conclusion: Our study sample had 9.45% male HFI, which is remarkable. Although estrogen has been the main driver in HFI etiopathogenesis, the reported rate in males will illuminate fresh research and conclusions, allowing a full study of alternative variables.

Anahtar Kelimeler

• Hyperostosis frontalis interna
• Acromegaly
• Postmenopausal women
• Calvarial growth
• Heterotopic ossification

Kaynakça

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