RESUMO
OBJECTIVE: Adult subjects with isolated growth hormone deficiency (IGHD) due to a mutation in the growth hormone releasing hormone receptor gene exhibit higher values formant frequencies. In normal subjects, a significant negative association between the formant frequencies and the reduction of linear craniofacial measurements, especially of maxilla and mandible, has been reported. This suggests smaller pharyngeal width, despite low prevalence of obstructive sleep apnea syndrome. Here we evaluate their pharyngeal airway width, its correlation with vowel formant frequencies, and the correlation between them and the craniofacial measures. SUBJECTS AND METHODS: A two-step protocol was performed. In the first case-control experiment, aimed to assess the pharyngeal width, we compared nine adult IGHD and 36 normal statured controls. Both upper and lower pharyngeal widths were measured. The second step (assessment of pharyngeal width) was performed only in the IGHD group. RESULTS: Upper and lower pharyngeal widths were similar in IGHD and controls. In IGHD subjects, the lower pharyngeal width exhibited a negative correlation with F1 [a] and a positive correlation with mandibular length. There were negative correlations between F1 and F2 with linear and positive correlations with the angular measures. CONCLUSIONS: Pharyngeal airway width is not reduced in adults with congenital, untreated lifetime IGHD, contributing to the low prevalence of obstructive sleep apnea syndrome. The formant frequencies relate more with cephalometric measurements than with the pharyngeal airway width. These findings exemplify the consequences of lifetime IGHD on osseous and nonosseous growth.
Assuntos
Nanismo Hipofisário , Adulto , Cefalometria , Hormônio do Crescimento , Humanos , Mandíbula/diagnóstico por imagem , Faringe/diagnóstico por imagemRESUMO
ABSTRACT We report the case of a 32-year-old male patient, who was subjected to cone-beam tomography for planning the removal of an unerupted tooth. Cone-beam CT scans revealed the presence of a mixed lesion with poorly defined limits in the left posterior mandibular region, with "sun-ray" periosteal reaction. An incisional biopsy was performed and the diagnosis was chondroblastic osteosarcoma. In this paper, a discussion of the differential diagnosis criteria and treatment of this unusual malignant neoplasm is performed. Thus, it is intended to provide information that will help in the study of management protocols for the increasingly effective treatment of gnathic osteosarcomas.
RESUMO Relatamos o caso de um paciente do sexo masculino, 32 anos de idade, que realizou tomografia cone-beam para planejamento de remoção de dente incluso. O exame revelou presença de lesão mista de limites mal definidos na região posterior mandibular esquerda, com reação periosteal em "raios de sol". Foi realizada biópsia incisional, e o diagnóstico foi de osteossarcoma condroblástico. Neste trabalho, será realizada uma discussão dos critérios de diagnóstico diferencial e do tratamento dessa neoplasia maligna. Pretende-se, dessa forma, trazer informações que auxiliem no estudo de protocolos de conduta para o tratamento cada vez mais efetivo dos osteossarcomas gnáticos.