The Effects of Pituitary Adenoma on the Facial Skeleton in Cases of Acromegaly

Abstract

Typical clinical signs of long-lasting overproduction of growth hormone in adults such as enlargement of the feet, hands, mandible, and nose allow the diagnosis of a pituitary adenoma in cases of acromegaly at first sight. Since most of the bony changes are not reversible (Kinnmann 1976), it would be of great value if an acromegaly could be diagnosed before visible changes are present. In addition, not all patients develop the typical deformations, and therefore the time between the first manifestation of the disease and the beginning of treatment may be quite long (Landolt 1986). Nonspecific symptoms such as headache and amenorrhea generally lead the patient with an acromegaly first to a dentist, general practitioner, or gynecologist rather than to a neurosurgeon.