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Bone exostosis is defined as a benign overgrowth of bone tissue of unclear origin. Rarely, bone exostosis might develop following soft tissue graft procedures like mucogingival surgical interventions (eg, FGG or subepithelial CTG). This aberration has been mainly associated with surgical trauma or fenestration of the periosteum but is still a matter of debate. The present paper (1) presents a clinical case with clinical, radiographic, and histologic findings at 30 years following application of an FGG to increase the gingival width and (2) provides a short literature review on this particular clinical condition. At the clinical examination, the FGG was firm to palpation, and the 3D images showed an area of increased radiopacity. Histologic analysis revealed localized thickening of the bone with an overlaying connective tissue covered by keratinized epithelium. The bony tissue was vital, had a convex shape, and contained many osteocytes and resting lines, demonstrating some moderate signs of bone remodeling. The connective tissue and keratinized epithelium displayed a regular thickness without any signs of inflammation. Taken together, the histologic findings failed to reveal any pathologic signs except for the presence of vital bone formed outside the bony envelope. It can be concluded that: (1) the development of a bone exostosis following a mucogingival procedure is a rare clinical sequela of uncertain etiology, and (2) surgical removal of the exostosis may be indicated accordingly with patient symptoms. [ABSTRACT FROM AUTHOR]

Background: Port-wine stains (PWS) are congenital low-flow vascular malformations of the skin. PWS tend to become thicker and darker with time. Laser therapy is the gold standard and the first-line therapy for treating PWS. However, some resistant PWS, or PWS that have tissue hypertrophy, do not respond to this therapy. Our aim is to evaluate the role of surgery in the treatment of PWS birthmarks. Methods: A literature search was performed in PubMed, Scopus, Web of Science (WOS) and Google Scholar for all papers dealing with surgery for port-wine stains, from January 2010 to December 2020 using the search strings: (capillary vascular malformation OR port-wine stains OR Sturge Weber Syndrome OR sws OR pws) AND (surgical OR surgery). Results: Ten articles were identified and used for analysis. They were almost all case series with a short follow up period and lacked an objective–systematic score of evaluation. Conclusions: Delay in treatment of port wine stains may result in soft tissue and bone hypertrophy or nodules with disfiguring or destructive characteristics. The correction of PWS-related facial asymmetry often requires bone surgery followed by soft tissue corrections to achieve a more harmonious, predictable result. [ABSTRACT FROM AUTHOR]

Simple summary: Suture exostosis is a condition affecting the horse's head. The connections between the bone plates that form the horse's face have been shown to react to insult. Horses will then develop a swelling along the face that may be painful. Little is known about this condition and the present research project aimed to investigate horses presented to equine clinics with symptoms of the disorder. It was revealed that the condition can form following trauma, underlying sinus disease, following a surgery or without any apparent cause. Various treatment options to resolve the condition have been reported and the outcomes of those are described in the paper. Most consistently the proper diagnosis and identification and removal of potential bone sequestra are crucial for a timely resolution. Suture exostosis is an intriguing and not uncommon pathology that has to be included in the differential diagnosis for horses with swelling of the head. Although several singular case reports have been published, no large case series is available. The aim of this study is to report a multicentric retrospective collection of suture exostosis cases. Data concerning horses with suture exostosis in the facial region were collected retrospectively. Information regarding breed, age, gender, history, imaging findings, initiated treatment, response to treatment and follow up was recorded. One hundred and five cases of various breeds were reported. Analysis revealed the cases could be grouped into four entities: 45 developed following sino-nasal surgery, 23 following trauma, seven with underlying sinus pathology and 25 idiopathic. Treatment consisted of sequestra removal, plate fixation, antimicrobial and anti-inflammatory drugs or no treatment. Whereas initial localized pain fades within few days or weeks, resolution or reduction of the swelling was obtained in most cases after 3 months to 1.5 years. The etiopathogenesis of suture exostosis seems to consist of different entities. Identification of an underlying cause, particularly the presence of a bone sequester and infection is important to speed up resolution and before concluding an idiopathic case. When performing sinusotomies, it is important to provide as little trauma as possible to the surgical site in order to prevent suture exostosis as a complication. [ABSTRACT FROM AUTHOR]

Objectives: Diffuse idiopathic skeletal hyperostosis (DISH) has recurrently been associated with a rich diet (high in protein and higher trophic level foods); however, very few studies have investigated this link using carbon and nitrogen (δ13C and δ15N) stable isotope analysis. This paper explores the relationship between DISH and diet in two Roman urban communities by analyzing individuals with and without DISH. Materials and methods: δ13C and δ15N analysis carried out on collagen from 33 rib samples (No DISH: 27; early DISH: 4; DISH: 2) selected from individuals buried at the Romano‐British site of Baldock (UK), 41 rib samples (No DISH: 38; early DISH: 3) from individuals from the Catalan Roman site of Santa Caterina (Barcelona, Spain). Additionally, six faunal samples from Baldock and seven from Santa Caterina were analyzed. Results: Standardized human isotope data from Santa Caterina show high δ15N probably associated to a diet combining terrestrial resources and freshwater fish. In contrast, isotope results from Baldock suggest a terrestrial‐based diet. Individuals with DISH do not show isotopic ratios indicative of rich diet and there is no correlation between stage of DISH development and δ13C and δ15N. Conclusion: The results of this study suggest that individuals with DISH followed a similar or isotopically similar diet as those individuals without DISH in Baldock and in Santa Caterina and therefore, while DISH may have been influenced by individual's dietary habits, this is not reflected in their isotopic signature. [ABSTRACT FROM AUTHOR]

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Klippel-Trenaunay-Weber syndrome (KTWS) is a rare disease characterized by vascular malformations, port-wine staining, and soft tissue and bone hypertrophy. Lesions occur in the lower extremities in 95% of cases, whereas only 5% occur in the upper extremities. Several case reports have described the treatment of fractures in the lower extremities in patients with KTWS. However, the risk of massive bleeding, bone deformity, and poor bone quality can lead to suboptimal surgical outcomes. No reports describing the treatment of forearm shaft fractures in KTWS could be found in the English-language literature. Intramedullary nailing is difficult due to the deformed bone and the risk of nonunion. Open reduction and internal fixation (ORIF) should be considered with caution in KTWS patients due to the risks of intraoperative bleeding and wound problems. The authors report that satisfactory results were obtained with ORIF after preoperative vascular embolization in a 60-year-old KTWS patient with fractures in both bones of the forearm. [ABSTRACT FROM AUTHOR]

Presents an abstract of the study `Porotic Hyperostosis in Spanish Florida: Nature and Etiology of a Frequently Observed Phenomenon' by M. Schultz and C.S. Larsen.

Presents an abstract of the study `Microscopic Differential Diagnosis of so called Cribra Orbitalia--A Contribution to the Etiology of Orbital Porotic Hyperostosis' by P. Carli-Thiele and M. Schultz.

Presents an abstract of the study `Subsistence activity and humeral hypertrophy among western Aleutian Islanders,' by K.A. Berget and S.E. Churchill. Factors behind elevated humeral robusticity and muscularity in Aleut males; Studies of enthesopathies in the postcrania of both sexes.

Costal osteocartilaginous exostoses, also known as osteochondromas, are the most common neoplasms of the long bones but are rare tumors of the ribs. Osteochondroma is often asymptomatic and incidentally observed. Tumors typically begin to grow before puberty and continue until bone maturation is reached. Our paper presents the case of a 16-year-old young male who was admitted to the hospital with nonspecific symptoms and having a family history of exostosis. Chest X-ray and computed tomography imaging revealed multiple costosternal exostoses, manifested as mediastinal masses, with protrusion into the thoracic cavity, exerting compressive effects on the ascending aorta and pulmonary parenchyma. Surgery is required in childhood if lesions are painful. But if tumor formation occurs in adulthood, such pathological bony outgrowths should always be resected for avoiding further complications. In this patient, surgical intervention removed the tumoral masses and improved the symptoms. Subsequently, histological exam confirmed the diagnosis of osteocartilaginous exostoses and showed the lack of dysplastic changes. [ABSTRACT FROM AUTHOR]

Copyright of Plastic Surgery & Burns / Chirurgia Plastyczna i Oparzenia is the property of Evereth Publishing Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In 2009, Walker and colleagues questioned the validity of the iron-deficiency anemia hypothesis as an explanatory mechanism for the presence of porotic hyperostosis (PH) and cribra orbitalia. They presented evidence demonstrating that iron deficiency inhibits, rather than promotes, marrow hypertrophy and argued a link between both PH and hemolytic or megaloblasic anemias (including vitamin B12 deficiency). This paper suggests that dismissing the iron-deficiency anemia hypothesis may be premature, but, if dismissed, may result in unforeseen consequences. Vitamin B12 deficiency and iron deficiency often result from similar proximate causes, i.e. lack of animal protein in the diet and sanitation problems that lead to parasitic or diarrheal diseases, thereby promoting nutrient losses. As a result, vitamin B12 deficiency and iron deficiency commonly co-occur. In individuals with a co-occurrence of iron deficiency and vitamin B12 deficiency, a possible inhibition of marrow hypertrophy caused by iron deficiency may prevent the development of PH, despite the presence of (vitamin B12) nutritional deficiency. The implications of dismissing the iron-deficiency anemia hypothesis are that many skeletal populations may exhibit hidden heterogeneity, i.e. individuals who are the most nutritionally stressed, with multiple nutrient deficiencies, would mimic the non-stressed individuals and neither would show evidence of PH. However, the inclusion of multiple stress indicators and greater understanding of biocultural context in bioarchaeological analyses may mitigate the potential impacts of hidden heterogeneity in the expression of PH. [ABSTRACT FROM AUTHOR]

Diffuse Idiopathic Skeletal Hyperostosis (DISH) also known as Forestier's disease, is a musculoskeletal disorder characterized by the calcification of ligaments essentially the vertebral longitudinal anterior ligament. Men are generally affected. It is often asymptomatic. The most common extraspinal clinical manifestation of this disease presents as dysphagia followed by respiratory disturbances such as dyspnea and sleep apnea. In this paper we discuss two cases where the patients have experienced progressive dysphagia. Radiological findings were compatible with DISH. The management was based on diet modification and anti-inflammatory medication. [ABSTRACT FROM AUTHOR]

This paper presents congenital anomalies characteristic of Klippel–Feil syndrome, type II, diagnosed in the skeleton of a young to middle‐aged woman uncovered in a cemetery adjacent to the Church of St. Jacob the Apostle in Wągrowiec (Poland), from a grave within an archaeological layer dated to the 14th–17th centuries. A rare type of fusion was identified between the sixth and seventh cervical vertebrae only, co‐occurring with a well‐developed right cervical rib fused to the shaft of the first thoracic rib and articulated via synovial joints with the seventh cervical vertebra. The fusion of the cervical vertebrae involved their bodies, right laminae, and parts of the right articular processes. The interpretation of the presence of Klippel–Feil syndrome is additionally supported by the absence of any evidence of trauma in the cervical region of the spine or of pathological changes in the skeleton indicative of diffuse idiopathic skeletal hyperostosis or ankylosing spondylitis. The formation of Schmorl's nodes and degenerative changes in apophyseal joint surfaces diagnosed in the cervical vertebrae were probably secondary in relation to the observed congenital anomalies. Additionally, examinations revealed ossified insertions of the ligamentum flavum and degenerative changes of the vertebrae in the lower region of the spine as well as incomplete posterior bridge of the atlas, torus mandibularis, and humerus septal aperture. [ABSTRACT FROM AUTHOR]

Abstract: Intentionally opened skulls are considered to be the most fascinating of palaeopathological findings. This paper regards the discovery of a new trepanated skull dating from the Late Bronze and Early Iron Ages (1500–1400  BC) found at a burial site of Bardzryal, Armenia. Attention was first paid to trepanation technique, second—the description of methods of trepanations, third—to surgical procedures, and finally, to the cause of trepanation. The remains were examined by standard macromorphological and X‐ray methods of bioarchaeology. Bone nodules resulting from Dyke–Davidoff–Masson syndrome (DDMS) were observed on the endocranial surface of the frontal bone of a female. Regardless of provenance DDMS, which seems to be a possible cause of trepanation in women, is rarely seen in historic populations. Along with DDMS, porotic hyperostosis and osteomas were also observed. This observation constituted the first evidence of DDMS in the Late Bronze and Early Iron Age Armenia. [ABSTRACT FROM AUTHOR]

The paper reports on a collective burial from a 13th c. AD cist grave in Attica, Greece. The grave was located inside a basilica and held the remains of at least ten adults. Bone representation analysis showed secondary manipulation of previous deceased including long bone selection for reburial in the same grave and/or bones transported from a different burial place. Paleopathological analysis used macroscopy and radiology, and revealed several lesions on the axial and appendicular skeleton expressed mainly by spinal ligament ossification and multiple peripheral enthesopathies. Individuation of the remains pointed to a middle-aged male with DISH, a condition often correlated to high social rank. Byzantine period is marked by increasing development and prosperity in Greece including among others the creation of many local monastic centers. Although the precise social and professional profile of these individuals cannot be revealed, the combined investigation of skeletal and archaeological evidence suggests that the grave gathered the remains of individuals belonging to an upper class social group. [ABSTRACT FROM AUTHOR]

Background: Pediculolysis is bone hypertrophy and pseudoarthrosis caused by pedicle fracture and has often been combined with contralateral spondylolysis in previous reports. Multilevel pediculolysis with spondylolysis is extremely rare, and we report a case who underwent surgery. Cases of multisegment pediculolysis were reviewed to inspire the diagnosis and treatment of similar pathological phenomena. Case presentation: A 55-year-old man suffering from low back pain and sciatica was admitted to hospital after failing conservative treatment. The imaging studies revealed bilateral pediculolysis at L3 and L4 and right spondylolysis at L5. When L2-5 internal fixation and fusion surgery were performed, the symptoms improved immediately after surgery. At the 2-year postoperative follow-up, proximal junctional failure appeared and progressively worsened. Conclusions: Multilevel pediculolysis often requires surgical intervention, and segment instability is an important consideration in the development of surgical fusion strategies. The etiology of pediculolysis is still complex and unknown, and the spondylolysis protocol can be used as a reference for treatment. Surgeons should be cautious in surgical planning to minimize the likelihood of postoperative instrumentation failure. [ABSTRACT FROM AUTHOR]

Background:Lesions arising in the external auditory canal that require surgical excision are uncommon. They are associated with a range of pathologies, including bony abnormalities, infections, benign and malignant neoplasms, and epithelial disorders.Methods:This paper describes a 10-year personal case series of external auditory canal lesions with chart, imaging and histopathology review.Results:In total, 48 lesions required surgical management, consisting of: 13 bony lesions; 14 infective lesions; 14 neoplasms with 11 histological types (including ceruminous adenoma and the extremely rare cavernous haemangioma); 3 epithelial abnormalities; and 4 other benign lesions. The surgical management is described.Conclusion:This study emphasises the diagnostic differences between exostoses and osteomas, and between external auditory canal cholesteatoma and keratosis obturans. It also discusses the management of aural polyps, and highlights the need to excise external auditory canal masses for histology in order to guide subsequent treatment. [ABSTRACT FROM AUTHOR]

Castleman's disease (CD), diffuse idiopathic skeletal hyperostosis (DISH), and ossification of the posterior longitudinal ligament of the spine (OPLL) are three different entities. Castleman's disease displaying a variety of calcifications in the abdomen and/or pelvis has been reported in some papers. However, there were no reports suggesting an association between CD and ossification/calcification in spine and joints. So far, there has been no case report regarding the coexistence of these diseases in the literature. Herein, we detail a 75-year-old man suffering from CD who demonstrated the features of DISH with coexisting features of OPLL. The cardinal symptoms such as fatigue, high fever, and swollen glands in this case were reduced by corticosteroid therapy. However, it is possible to produce actual symptoms of ossifying/calcified diathesis of entheses and ligaments as a consequence, like the pathology of calcification found in the region of the spleen. In this paper, we describe this patient in order to discuss the association of these diseases. [ABSTRACT FROM AUTHOR]

Palmoplantar pustulosis (PPP) is a rare chronic inflammatory disease, characterized by the recurrent appearance of sterile pustules. PPP is one of the skin manifestations that can occur in patients with SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, osteitis), a rare syndrome, characterized by the association of various forms of arthropathy and neutrophilic skin conditions. In this paper, we present the case of a patient with palmoplantar pustulosis and osteoarticular pain in the left hemithorax and left sternocostal joint that raised the suspicion of SAPHO syndrome. [ABSTRACT FROM AUTHOR]

This paper reports a case of multiple osteochondromas affecting the antlers and the left zygomatic bone of a free-ranging adult white-tailed buck (Odocoileus virginianus) from Georgia, USA. Along with a few postcranial bones, the antlered cranium of the individual was found in a severely weathered condition and devoid of any soft tissue. The antlers exhibited five pedunculated exostoses that were composed of cancellous bone and, in their peripheral portions, also mineralized cartilage. The largest of the exostoses, located on the right antler, had a maximum circumference of 55 cm. The exostosis arising from the zygomatic bone was broad-based and much smaller than the exophytic outgrowths on the antlers. Diagnosis of the exostoses as osteochondromas was based on their overall morphology, the normal bone structure in their stalk regions, and the continuity of their spongiosa and cortex with the respective components of the parent bones. Antleromas, i.e., pathological outgrowths developing on antlers as a result of insufficient androgen production, were excluded in the differential diagnosis, based on (1) the apparent maturity and, except for the tumors, normal shape of the antlers and (2) the fact that exostosis formation had also affected the zygomatic bone. Previously only a single case of solitary osteochondroma of an antler has been described in the scientific literature. The case presented here is the first report of multiple osteochondromas in a deer. As antlers are regularly collected as trophies, and huge numbers of them are critically inspected each year, the fact that thus far only two cases of antler osteochondromas have been reported suggests that these tumors are very rare. [ABSTRACT FROM AUTHOR]

An amendment to this paper has been published and can be accessed via a link at the top of the paper. [ABSTRACT FROM AUTHOR]

Introduction. The anomalies of the size and shape of the foramen magnum (FM), followed by its stenosis, take a special place in clinical and forensic practice. The clinical picture of FM stenosis is variable, but it is not specific, which is why these anomalies are sometimes not recognized in time and are only detected by autopsy. Case report. This paper analyzes the case of a sudden death caused by the unusual shape of the FM stenosis. On autopsy, we found exostoses on the front and rear edges of the FM with their prominence into the FM. The exostoses reduced the sagittal diameter of the FM and practically divided it into two asymmetric semicircles, which is why we called this stenosis the "keyhole" stenosis of the FM. This form of the FM stenosis pushes the medulla oblongata aside, resulting in its incarceration into one of the FM semicircles. Conclusion. A stenosis of the FM can represent a threat to life, especially when combined with its unusual shape, as in our case. In this way, the critical stenosis of the FM becomes clinically clearly manifested, and there is a loss of consciousness that can also end with a sudden death, as in our case. [ABSTRACT FROM AUTHOR]

In this brief anatomical and palaeopathological communication the authors detail the characteristics and alterations noted on the sternal body and xiphoid process of ST1, Sicily's earliest known female skeleton, dated to the Palaeolithic Period (14,500 years BP). A morphological and radiological analysis is offered both in terms of the relation between age and manifestation of the xiphisternal fusion, with a focus on ancient traumatology involving the soft tissues near the sternum to explain calcification of xiphoid and, more likely, the local presence of an exostosis. [ABSTRACT FROM AUTHOR]

Introduction: Hereditary multiple exostosis or hereditary multiple osteochondromas is a very rare clinical condition. Usually, these lesions tend to occur in the pediatric population, remaining silent until adulthood. Moreover, current studies show a small prevalence in the male population. The osteochondromas usually occur at sites with great bone activity and turnover, such as the diaphysis or metaphyseal plates (especially in children) of long bones. Their appearance in short bones (such as vertebrae) is very rare. Case presentation: We present a case of familial HME in a 53-year-old female patient with a very uncommon clinical description of the disease. The patient presented at our hospital with Frankel D-type paraparesis, with multiple osteochondromas (located at the right humerus, bilateral femurs, right tibia, and hip joints, besides the numerous ones over the spinal column) and urinary incontinence. She was suffering from bilateral coxarthrosis and gonarthrosis, which limited severely the range of her movements. An early menopause status was brought into consideration by the patient, being installed circa 15 years before, at 38 years old. She was currently in treatment with bisphosphonates for her concomitant osteoporosis. Conclusions: Despite the relatively rare nature of the disease, it may be an important concern for the patient's quality of life. Intraspinal processes may trigger paraparesis or other neurological statuses, which may require a surgical treatment. The nature of the lesions is usually benign and do not require further radio- or chemotherapy. [ABSTRACT FROM AUTHOR]

Objective: The main purpose of the present study was to evaluate whether complications related to surgery for exostoses are associated with a decrease in patients' quality of life. Methods: This was a retrospective study for which the following information was collected: sex, age, pre- and post-operative symptoms, pre- and post-operative audiological evaluation results, surgical approach, instruments used, complications, and Glasgow Benefit Inventory score. Results: The study included 67 patients (94 ears). The three main complaints reported were wax retention, otitis externa and hearing loss. Surgical complications occurred in 14.9 per cent of patients. Patients experienced a significant benefit from surgery, especially in relation to somatic state, with a global Glasgow Benefit Inventory score of + 44.3. No significant difference was found between the global Glasgow Benefit Inventory changes and surgery-related complications (p = 0.093). Conclusion: After surgery for exostoses, the vast majority of patients showed improvement. Complications related to surgery in general do not seem to influence patients' satisfaction with surgery. [ABSTRACT FROM AUTHOR]

Buccal exostosis is broad-based, non-malignant surface growth occurring on the outer or facial surface of the maxilla and/or mandible, found usually in the premolar and molar region. It begins to develop in early adulthood and may very slowly enlarge over the years. A 24-year-old female presented with gingival enlargement on the buccal aspect of both the quadrants of the mandibular arch, which was painless, self limiting, increase patient concern about poor esthetics, inability to perform oral hygiene procedures, and compromised periodontal health by causing food lodgment. The bony enlargement was treated with resective osseous surgery. The following paper presents a rare case of the bilateral mandibular buccal exostosis and its successful management. [ABSTRACT FROM AUTHOR]

A maxillary exostosis is a benign overgrowth of bone that occurs on the outer or facial surface of the maxilla and is usually located near the premolar or molar teeth. This paper investigates the correlation between the presence and growth of jaw exostoses and the oral mechanics of contact. For this purpose, a case study of an upper jawbone exostosis of a female patient was considered. 3D models of the patient's cranial bones were extracted from 2D computerized tomography (CT) data and were analyzed by proper software. A contact congruence evaluation based on the Winkler contact model was performed, and results were presented in terms of indentation maps and load distributions. Results were correlated with the theory of bone remodelling by Wolff. [ABSTRACT FROM AUTHOR]

This paper aimed to report a rare case of fusion of 6th and 7th cervical vertebrae, called as block vertebrae. Block vertebrae was observed in the Department of Anatomy, SRM Dental College. The bodies of C6 and C7 were completely fused. Anterioposterior radiograph of the fused vertebrae bodies showed hypoplastic inter vertebral disc. Lateral radiograph showed partial fusion of articular processes on left but remain unfused at the right side. Congenital cervical vertebral fusion results due to non-segmentation of sclerotomes. It may be asymptomatic or may result in various clinical symptoms with limitation of neck movements. Knowledge about the variations in vertebrae especially in cervical region is essential for orthopedic surgeons, oral- maxillofacial surgeons and physical therapists for planning any surgeries involving the neck region. [ABSTRACT FROM AUTHOR]

Buccal exostosis is benign, broad-based surface masses of the outer or facial aspect of the maxilla and less commonly, the mandible. They begin to develop in early adulthood and may very slowly enlarge over the years. A 24-year-old female presented with gingival enlargement on the buccal aspect of both the quadrants of the maxillary arch. The overgrowth was a cosmetic problem for the patient. The etiology of the overgrowth remains unclear though the provisional diagnosis indicates toward a bony enlargement, which was confirmed with the help of transgingival probing. The bony enlargement was treated with resective osseous surgery. The following paper presents a rare case of the bilateral maxillary buccal exostosis and its successful management. [ABSTRACT FROM AUTHOR]

Background: External auditory canal exostoses are known to occur in patients who engage in cold-water sports. Although the majority of patients with exostosis remain asymptomatic, larger lesions can cause wax impaction, conductive hearing loss and predispose to recurrent otitis externa. Objective: A novel technique is described of using a piezo saw to excise exostoses that are symptomatic. The piezo saw is used to perform various procedures, but its use in removing exostoses has not been described in the literature. Conclusion: Excision of exostoses of the ear canal using a piezo saw is a safe technique and patients have a speedy recovery. This paper describes a new technique for removing exostoses. [ABSTRACT FROM AUTHOR]

SAPHO syndrome is a complex disease that encompasses both inflammatory arthritis and/or osteitis and dermatologic manifestations. It is considered a rare disease, in fact, no clinical trials have been conducted on its therapy and management. Therefore, therapeutic approach is based on small case studies. Here, we described the case of a 63-year-old woman affected by SAPHO syndrome, treated with the selective IL-23p19 antagonist, Risankizumab, after unsuccessful therapies with Methotrexate, Infliximab, Adalimumab, and an allergic reaction to Secukinumab. At the beginning of therapy, in November 2022, the patient presented with arthritis in both knees associated with palmar pustulosis and guttate psoriasis on the trunk. DAPSA score was 24, PtGA 80 mm, PASI score 11.1, and BSA 40%. Thereafter, Risankizumab was started at the standard dosage of 150 mg. At week 24 patient achieved clinical remission, DAPSA score was 8, PtGA was 30 mm, PASI was 1, and BSA 2.5. Patient maintained clinical remission state at the subsequent week 52 evaluation. At the same time, the patient did not report any adverse effects. Health-related quality of life was also assessed at the same time points aforementioned, showing significant improvement. In conclusion, this case report wants to point out the efficacy and safety of Risankizumab in SAPHO syndrome, reporting a sustained disease remission through a 12 months long follow-up period. We can consider IL-23p19 targeted therapy as a novel treatment option for SAPHO—with a high efficacy potential—especially on patients that have already been treated with other biologics. [ABSTRACT FROM AUTHOR]

Copyright of Medical Bulletin of Haseki / Haseki Tip Bulteni is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Ortopédica Mexicana is the property of Sociedad Mexicana de Ortopedia, AC and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this paper is to show that osteochondromas of the cervical vertebrae can cause myelopathy and neck pain. The reported etiology , diagnosis , treatment and differential diagnosis were reviewed. Osteochondromas may present as a solitary lesion with no genetic component or as multiple lesions as a part of a genetic disorder known as hereditary multiple exostosis. Osteochondromas of the spine are rarely encountered in clinical practice. These lesions are reported more commonly with neural compression in cases associated with hereditary multiple exostosis. The authors describe a unusual clinical manifestation of a solitary osteochondroma located in the rig ht posterior arch of the atlas. Complete removal of the tumor was performed resulting in the relief of neck pain and spastic quadriparesis. Although unusual , osteochondromas of the cervical spine must be considered in patients with persistent neck pain and progressive symptoms of myelopathy. Computed tomography and magnetic resonance imaging in conjunction with plain radiograms is the neuroradiological modality of choice. The diagnosis and surgical excision of these tumors are important because they can cause spinal stenosis resulting in neural tissue compression and myelopathy. [ABSTRACT FROM AUTHOR]

Infantile cortical hyperostosis (ICH, OMIM 114000) is a rare familial disorder which affects infants. It spontaneously heals in the first years of life. The disease is characterized by regressive subperiosteal hyperosteogenesis mainly affecting long bones, mandible, clavicles, and ribs which are remarkably swollen and deformed on X-rays. But it is also important to take into consideration the autosomal dominant pattern of inheritance to detect it. In 2005 Gensure et al. detected 3040C → T mutation in COL1A1 gene in three unrelated ICH families. Four generations of patients belonging to the same family were examined in our study. Molecular testing has now disclosed a pathogenic mutation in nine of them. The patients spontaneously recovered. Although our paper shows a distinct correlation between R836C mutation and ICH, there is a certain interindividual and intra-familial variability. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Medianae is the property of Acta Medica Medianae and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

History of underwater diving dates back to antiquity. Breath-hold technique in diving was known to the ancient nations. However, deep diving progressed only in the early decades of the 19th century as the result of advancements in efficient underwater technologies which subsequently led to invention of sophisticated sets of scuba diving in the 20th century. Currently, diving is performed for various purposes including commercial, recreational, military, underwater construction, oil industry, underwater archeology and scientific assessment of marine life. By increasing popularity of underwater diving, dive-related medical conditions gradually became more evident and created a new challenge for the health care professionals, so that eventually, a specialty the so-called "diving medicine" was established. Most of the diving-associated disorders appear in the head and neck. The most common of all occupational disorders associated with diving are otologic diseases. External otitis has been reported as the most common otolaryngologic problem in underwater divers. Exostosis of the external ear canal may be formed in divers as the result of prolonged diving in cold waters. Other disorders of the ear and paranasal sinuses in underwater divers are caused by barometric pressure change (i.e., barotraumas), and to a lesser extent by decompression sickness. Barotrauma of the middle ear is the most prevalent barotrauma in divers. The inner ear barotraumas, though important, is less common. The present paper is a brief overview of diving-related ear disorders particularly in scuba divers. [ABSTRACT FROM AUTHOR]

Abstract  In this paper, we describe a forensic paleopathology case using findings obtained from images of a skull with leontiasis ossea. This unique specimen is on display in the National Museum of Anthropology and History in Mexico. The skull shows tissue overgrowth, periosteal bone proliferation, which produced a cortical and diploid thickening involving the entire bone matrix. The study of images, X-rays, and helical computed tomography revealed generalized hyperostosis obliterating the maxillary and sphenoid sinuses, and two exuberant bony masses arising from the maxilla with encroachment of the anterior nasal opening. In order to reconstruct an image of the external appearance in life, a copy was obtained in the first place, using a stereolithography machine, after that, three-dimensional (3-D) facial reconstruction technique was applied, thus an approximation of the external appearance of this specimen was obtained. During the process, we encountered several difficulties, mainly when interpreting the cortical topography, the position of eyes and mouth. In this sense, facial reconstruction allows only for a moderate investigation due to the limited information that can be obtained from the skull and the significant alterations observed. [ABSTRACT FROM AUTHOR]

The combination of multiple exostoses (EXT) and enlarged parietal foramina (foramina parietalia permagna, FPP) represent the main features of the proximal 11p deletion syndrome (P11pDS), a contiguous gene syndrome (MIM 601224) caused by an interstitial deletion on the short arm of chromosome 11. Here we present clinical aspects of two new P11pDS patients and the clinical follow-up of one patient reported in the original paper describing this syndrome. Recognised clinical signs include EXT, FPP, mental retardation, facial asymmetry, asymmetric calcification of coronary sutures, defective vision (severe myopia, nystagmus, strabismus), skeletal anomalies (small hands and feet, tapering fingers), heart defect, and anal stenosis. In addition fluorescence in situ hybridisation and molecular analysis were performed to gain further insight in potential candidate genes involved in P11pDS.European Journal of Human Genetics (2004) 12, 400-406. doi:10.1038/sj.ejhg.5201163 Published online 11 February 2004 [ABSTRACT FROM AUTHOR]

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) is a rare chronic inflammatory disease that develops in adults. We present a case of SAPHO syndrome in a 37‐year‐old male presenting with gradually worsening back and neck pain for a 7‐year period. The episodes were preceded by a history of pustular skin eruptions, which first appeared on the upper trunk and then involved his face and were pustular and scarring. The purpose of presenting this case report from Iraq is to raise awareness about this rare condition, which is frequently misdiagnosed and under‐recognized. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the frequency of ear canal protection use and looked at its influence on external auditory exostosis severity and knowledge about external auditory exostosis among windsurfers and kitesurfers on the German coast. Method: This retrospective cross-sectional study interviewed 130 windsurfers and kitesurfers along the German coast on knowledge of external auditory exostosis, exposure time, use of neoprene hoods and earplugs, and otological complaints. Participants underwent bilateral video-otoscopic examination. Results: Knowledge of external auditory exostosis was 'good' or 'excellent' in 78 of 130 (60 per cent) individuals and 'poor' or non-existent in 52 of 130 (40 per cent) individuals. Knowledge was positively correlated with hours of exposure, otological complaints and frequency of ear canal protection use. A significant negative influence of neoprene hood use on external auditory exostosis severity was shown. Conclusion: The positive effect of external auditory exostosis knowledge on the frequency of ear canal protection and the reduction of external auditory exostosis risk implies a need for health education on this topic. [ABSTRACT FROM AUTHOR]

Children with an exostosis-related Bessel-Hagen [[8]] disease or an Ollier disease [[9]] need to be checked regularly during growth, and the operative indication needs to be set at R > U + 20 mm, with monitoring set at R > U + 10 mm. The difference is in the nature of chondromas: enchondromas with risk of severe degeneration for the Ollier disease and exochondromas for hereditary multiple exostosis, also known as Bessel-Hagen disease [[8]] (the history matters). In my own work, 10/14 patients had a Bessel-Hagen disease, and 4/14 had an Ollier disease. [Extracted from the article]

Abstract In this paper we describe macroscopically two types of bone lesions on a caudal vertebra of an indeterminate titanosaur recovered from the Lower-Upper Cretaceous (Albian-Cenomanian) Açu Formation in the Potiguar Basin, Brazil. The first type of lesion corresponds to cystic lesions on cranial and caudal joint surfaces of the vertebral body, which are identified as subchondral cysts. The second type of lesion corresponds to an irregular bone overgrowth located on longitudinal ligament insertion points. This ossification can be associated with an axial spondyloarthropathy or diffuse idiopathic skeletal hyperostosis (DISH). Bone overgrowth on vertebrae is well documented in the dinosaur fossil record, whereas this is only the second case recorded of subchondral cysts. [ABSTRACT FROM AUTHOR]

The history of neurosurgery is ever fascinating. The journey has been tedious; nevertheless, in the landscape of success and failures we have become more efficient and polished. Skills were learned, innovations were made, and in the process we evolved. The immense contribution of meningioma surgery in this maturation process is attested by history itself. Countless stories that testify the momentous role of meningioma in the process of evolution and reformation of neurosurgical techniques exist in the literature. With every step and every attempt at conquering this tumor, we reformed to be better surgeons, more skilled and more precise. In this paper we have walked down the lane of neurosurgery and paid a due tribute to this "necessary evil." Highlights • Innovative ideas and clinical discoveries of our forefathers led to modern-day neurosurgery in its current state of art. • The immense contribution of meningioma surgery in this maturation process is attested by history itself. • Countless stories testify to the momentous role of meningioma in the evolution/reformation of neurosurgical techniques. • In this article we attempted to reminisce the memoir of neurosurgery and pay tribute to a "necessary evil." [ABSTRACT FROM AUTHOR]

This paper describes the radiological findings obtained in 20 patients with the Cornelia de Lange syndrome. The pattern profiles of the hand skeleton were studied in these patients, using the method described by Poznanski et al. This study revealed a short first metacarpal bone, combined with relatively long third and fourth metacarpals, to be the most characteristic feature of the syndrome. No radiological characteristic was found to be pathognomonic of the syndrome, but the combination of a deformed proximal metaphysis of the radius with the above mentioned abnormality in the pattern profile of the hand is described as highly suggestive of the Cornelia de Lange syndrome. [ABSTRACT FROM AUTHOR]