MISCELLANEOUS AFFECTIONS OF THE SINUSES 87
FACIAL FIBROUS DYSPLASIA
This denotes a unilateral fibro-osseous thickening of the frontal bone or the
alveolar border of the maxilla, and it is most often found in young women
between the ages of 10 and 20 years. It is a rare condition which in the
maxilla results in a unilateral broadening of the alveolus which presents a
smooth surface with a normal mucosal covering from which the teeth project
Fig. 41. Radiograph of the paranasal sinuses, demonstrating a cyst containing a tooth in the maxillary
only to a slight extent. The cavity of the maxillary sinus may become obliter-
ated. The only complaint is of toothache. In the frontal region there is a
unilateral swelling over the frontal sinus.
The condition as it affects the maxilla must be distinguished from a dental
cyst by the absence of a crackling sensation on palpation of the swelling; and
from a malignant tumour by its slow growth and the absence of pain. Fibrous
dysplasia of the frontal region must be differentiated from osteomyelitis by its
painless nature and by the fact that there is no general ill-health. The diagnosis
is confirmed by histology of the tissue after removal.
Should treatment be called for in the maxillary type it consists in reflecting
the mucosa and trimming the vascular cancellous new bone. In the frontal
region cosmetic trimming may be required. Recurrence is unlikely because
growth ceases about the age of 20 when skeletal growth stops.
Hypophysectomy is performed on the normal pituitary gland for the control
of carcinoma of the breast or of the prostate, or in Cushing's syndrome. The