gms | German Medical Science

82nd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

01.06. - 05.06.2011, Freiburg

Olfactory dysfunction as first presenting symptom of cranial fibrous dysplasia

Meeting Abstract

  • corresponding author Evangelia Tsakiropoulou - Papageorgiou Hospital, Thessaloniki, Greece
  • Iordanis Konstantinidis - Papageorgiou Hospital, Thessaloniki, Greece
  • Aggelos Chatziavramidis - Papageorgiou Hospital, Thessaloniki, Greece
  • Jannis Constantinidis - Papageorgiou Hospital, Thessaloniki, Greece

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 82. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Freiburg i. Br., 01.-05.06.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11hnod672

DOI: 10.3205/11hnod672, URN: urn:nbn:de:0183-11hnod6722

Published: April 19, 2011

© 2011 Tsakiropoulou et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Introduction: Fibrous dysplasia is a relatively common disorder of bones. However, cranial fibrous dysplasia comprise less than one percent of all primary bone lesions. Although a variety of clinical manifestations exists, olfactory dysfunction as the presenting symptom is very rare.

Case Report: We present a 72-year-old female patient with a 3-year history of olfactory dysfunction and chronic rhinosinusitis. Clinical examination including nasal endoscopy revealed polypoid middle meatal mucosa. Psychophysical testing using Sniffing Sticks battery showed severe hyposmia. The patient received a course of oral corticosteroids without any improvement. Further investigations included computed tomography and magnetic resonance imaging of the brain. Bony lesions of the right temporal and sphenoid bone with extension to the cavernous sinus were found. Imaging findings were characteristic of polyostotic type fibrous dysplasia. Plain x-rays of skeletal bones did not show other lesions. Localization of the lesion along with the age and general condition of the patient did not permit removal of dysplastic bone. The patient remains in a close follow up.

Conclusion: This case confirms the need of imaging studies in patients with rhinosinusitis without response to steroid treatment. Radiology may be adequate for diagnosis of fibrous dysplasia without the necessity for histological confirmation. The place of limited surgical treatment for the craniofacial lesions is debated.