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Craniometaphyseal and craniodiaphyseal dysplasia, head and neck manifestations and management

Richards, A; Brain, C; Dillon, MJ; Bailey, CM; (1996) Craniometaphyseal and craniodiaphyseal dysplasia, head and neck manifestations and management. Journal of Laryngology and Otology , 110 (4) 328 - 338. 10.1017/S0022215100133560. Green open access

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Abstract

Craniometaphyseal and craniodiaphyseal dysplasia are rare genetic disorders of bone due to modelling errors of long bones and skull bones. These syndromes present with multiple ENT symptomatology from an early age. The diagnostic distinction can now be made radiologically by serial skeletal survey which is important for prognosis. We review the clinical, radiological, computed tomography (CT) scan, otological, audiological and histopathological findings in two cases with craniodiaphyseal, and two cases with craniometaphyseal dysplasia, and report our experiences of medical and surgical treatment to date. In the craniodiaphyseal dysplasia, the hearing abnormality progressed from an initial conductive to a mixed loss on serial audiometric follow up. Temporal bone CT scans showed narrowing of the middle ear cavity, internal auditory meatus, and facial nerve canal at the geniculate ganglion. Benefits from choanal stenosis surgery, craniofacial remodelling and dacrocystorhinostomy were shortlived. Calcitriol therapy with a low calcium diet did not alter the clinical course of progression in our cases. The underlying defect, causing net bone formation in these phenotypically similar syndromes, appears to be different when based on the differing biochemical responses to calcitriol and bone biopsy findings. Increased numbers of osteoblasts were found in bone biopsies from both cases with craniodiaphyseal dysplasia. Early recognition is crucial in these conditions as therapy directed at the underlying bony defect has the best chance of success if initiated in infancy (Cole et al., 1988; Fanconi et al., 1988; Key et al., 1988).

Type: Article
Title: Craniometaphyseal and craniodiaphyseal dysplasia, head and neck manifestations and management
Open access status: An open access version is available from UCL Discovery
DOI: 10.1017/S0022215100133560
Publisher version: http://dx.doi.org/10.1017/S0022215100133560
Language: English
Additional information: Copyright Cambridge University Press 1996
Keywords: Craniometaphyseal dysplasia, Craniodiaphyseal dysplasia, Deafness, Choanal atresia, Nasal obstruction, Facial palsy, Osteoblast, Calcitriol
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
URI: https://discovery.ucl.ac.uk/id/eprint/34735
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