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At least 19 recordsLinked to original sources
PubMed1990

Radiographic findings in hereditary multiple exostoses and a new theory of the pathogenesis of exostoses.

Analysis of 330 exostoses in 18 patients affected by hereditary multiple exostoses disease suggested a new classification of exostoses as eccentric or full-thickness. Radiographically arrest of metaphyseal remodeling with failure of coning and persistence of the primary metaphyseal trabeculae was evident in full-thickness exostoses. Similar bone lesions can be obtained experimentally with inhibitors of bone turn-over. A localized, peripheral defect in remodeling over a limited time can give a satisfactory explanation also for the origin of eccentric exostoses. The thesis that this is the basic mechanism of exostosis formation is presented.

Adolescent↗
PubMed1991

[Costal exostoses, complicated in the neonatal period, by brachial plexus paralysis. A distinct entity of exostoses?].

Two highly unusual cases of brachial plexus palsy due to compression by exostosis of the first rib in the neonatal period are reported. Etiologic diagnosis in these patients required elimination of other tumors of the first rib, including multiple exostoses. The contradictions found lead the authors to suggest individualization of a form of multiple exostoses different from classical multiple exostoses by a number of features including growth, complications, and inheritance. At present, it is not known whether this new entity carries the same risk of malignant transformation as classical multiple exostoses.

Bone Neoplasms↗
PubMed2000

Buccal and palatal exostoses: prevalence and concurrence with tori.

OBJECTIVES: The aims of this study were to investigate the prevalence and location of oral exostoses and the concurrence of buccal and palatal exostoses with tori. STUDY DESIGN: With clinical inspection and palpation, 960 Thais were examined for the presence or absence of torus palatinus (TP), torus mandibularis (TM), and exostoses. RESULTS: Of the 960 subjects studied, 26.9% exhibited exostoses. Exostoses were more common in the maxilla than in the mandible (5.1:1). In addition, most of the exostoses were located on the buccal aspect of the jaws. The prevalence of exostoses increased with age (P = .000). Exostoses were significantly more common in men than in women (62.4% vs 37.6%, P =.000). Exostoses were concurrent with TM more frequently than with TP (36.2% vs 20.6%). The highest concurrence of exostoses with tori was observed in subjects who had both TP and TM (42.6%). CONCLUSIONS: The occurrence of exostoses is related to increasing age. TM and exostoses may share the same causative factors, and functional influences may contribute. Our findings lend support to the hypothesis that the etiology of exostoses involves an interplay of multifactorial genetic and environmental factors.

Adolescent↗
PubMed1998

Concurrence of torus palatinus with palatal and buccal exostoses: case report and review of the literature.

Exostoses, also known as hyperostoses, are localized bony protuberances that arise from the cortical plate. These developmental anomalies, or hamartomas, frequently affect the skeletal jaw. Different types of exostoses have been described. Torus palatinus and torus mandibularis are two of the most common intraoral exostoses. Other types of exostoses, affecting the palatal aspect of the maxilla (palatal exostoses) or the buccal aspects of the jaws (buccal exostoses), are less commonly encountered. Concurrence of different forms of exostoses in the same individual is very rare. A 48-year-old woman manifesting excessive palatal exostoses, torus palatinus, and buccal exostoses is described. We present the clinical and histopathologic features and applied therapy and provide a comprehensive review of the current features of exostoses.

Alveolar Process↗
PubMed2002

The role of occlusal stress and gingival infection in the formation of exostoses on mandible and maxilla from Neolithic China.

Exostoses on the mandible and maxilla is a frequently observed bone growth of controversial aetiology. The aim of this study is to analyse environmental factors that may stimulate the formation of exostoses on different regions of the maxilla and mandible. Sixty-six well-preserved crania from Neolithic China were studied for the presence of buccal exostoses on the maxilla (BE) and lingual exostoses on the mandible (LME). Other oral health indicators, such as occlusal wear on molars, pathology of temporomandibular joint (TMJ), carious lesions, calculus accretion, periodontal disease, and antemortem tooth loss were recorded. Buccal maxillary exostosis was unusually common on the Neolithic skulls from China, which thus resemble the Sinantropus crania described by Weidenreich (1943). We report a significant Spearman correlation between BE and LME (rho = 0.54, P < 0.00001), suggesting a partially shared aetiology of these two types of exostoses. The highest correlations between either form of exostoses and any oral indicator of stress were found for pathology at TMJ (rho = 0.46, P < 0.0001 for both types of exostoses). Smaller but significant correlations were observed between LME and the age adjusted wear rate on lower molars, as well as between BE and indicators of oral/dental pathology, e.g. caries, calculus, periodontoses, and antemortem tooth loss. Both types of exostoses tended to increase in frequency with age, although a significant trend was observed only for BE. We conclude that formation of exostoses is a complex process that can be invoked by any agent causing damage and inflammation of gingival tissue. However, severe occlusal stress, which is often manifested in TMJ disorder, is the main environmental factor leading to exostosis development in genetically pre-disposed individuals.

Adult↗
PubMed1999

Prevalence of external auditory canal exostoses in surfers.

OBJECTIVE: To determine (1) the prevalence of external auditory exostoses in a population of surfers and (2) the relationship between the length of time spent surfing and the prevalence, severity, and location of the exostoses. DESIGN: Cross-sectional epidemiological study. SETTING: General community. PATIENTS: Three hundred seven avid surfers (93.5% males and 6.5% females; age distributions: 11.2% were < or =20, 67.9% were 21 to 40, 17.5% were 41 to 50, and 3.3% were >50 years). MAIN OUTCOME MEASURES: Questionnaires focusing on surfing habits (number of years, geographic region, and number of days per year of surfing) were correlated with otoscopic findings. A simple grading system was devised, based on the degree of external auditory canal stenosis. Grades of normal, mild, moderate, and severe corresponded to 100%, 99% to 66%, 65% to 33%, and less than 33% effective patent surface area, respectively. RESULTS: There was a 73.5% overall prevalence of external auditory exostoses and a 19.2% overall prevalence of osteomas in the group studied. Of 441 ears with exostoses, 54.2% were mild, 23.6% were moderate, and 22.2% were severe. Of individuals who had surfed for 10 years or less, 44.7% had normal ear canals and only 6% had severely obstructed auditory canals. In comparison, in the group that had surfed for longer than 20 years, only 9.1% had normal auditory canals and 16.2% were severely affected. Of surfers with no exostoses, 61.1% had surfed for 10 years or less. In contrast, of surfers with severe exostoses, 82.4% had surfed for more than 10 years. Finally, the lesions seemed to affect all external auditory canal quadrants equally. CONCLUSION: A positive association exists between the amount of time individuals spend surfing and the presence and severity of exostoses of the external auditory canal.

Adult↗
PubMedDate not supplied

Exostoses of the external auditory canal in Oregon surfers.

PURPOSE: The objectives of this study were to determine the cold water exposure necessary to produce exostoses of the external auditory canal in individuals who predominantly surf along the Oregon and/or the northern California coastline and to ascertain from surfers' otologic histories symptoms attributable to exostoses. MATERIALS AND METHODS: Free ear examinations were provided at two surf shops in northern Oregon. The ear canals were examined with an otoscope, and each surfer was given a summary score indicating the percentage of both canals that was obstructed by exostoses. Surfers were then categorized according to the number of years surfing and the number of sessions surfing per year. RESULTS: Twenty-one surfers met our criteria for analysis. The degree of ear canal obstruction significantly increased with increasing number of years surfing (P < .001) and with increasing number of sessions surfing per year (P < .01). The median summary scores were 7.5, 63.0, and 93.0 for individuals who respectively surfed between 1 and 5 years, between 6 and 15 years, and greater than 15 years. The median summary scores were 10.0 for individuals who surfed 50 sessions or less per year versus 87.5 for individuals who surfed greater than 50 sessions per year. Most surfers with exostoses had minimal complaints. Only one patient had a history of surgical treatment. CONCLUSION: Individuals who surf 5 years or less are unlikely to develop exostoses unless they are surfing greater than 50 sessions per year. Exostoses are typically a benign malady that do not require surgical therapy.

Adult↗
PubMedDate not supplied

Exostoses of the external auditory canal.

Exostosis of the external ear canal is a disease unique to man. It has been identified in prehistoric man, affecting the aborigines of the North American continent. Aural exostoses are typically firm, sessile, multinodular bony masses which arise from the tympanic ring of the bony portion of the external auditory canal. These growths develop subsequent to prolonged irritation of the canal. The large, primitive jaw of prehistoric man placed great mechanical stress on the tympanic ring. Chronic aural suppuration seen in the preantibiotic era was soon followed by exostoses. Today, prolonged contact of the external ear canal with cold sea water is the most prevalent cause (aquatic theory). As a result the disease is now essentially limited to coastal regions. In this way we have seen exostoses appear in different stages of the evolution of man as a result of mechanical, chemical and now thermal irritation. The author is an otolaryngologist in a coastal region. In examining 11,000 patients during a ten-year period, 70 cases of symptomatic exostoses of the external auditory canal were identified. The incidence of exostoses was found to be 6.36 per 1,000 patients examined for otolaryngologic disease. It is a predominantly male disease. The development of these "irritation nodules" is painless until the tenth year of aquatic exposure to irritation, when symptoms of obstruction occur. The hearing loss associated with exostoses is usually a conductive type, secondary to occlusion of the canal by impacted cerumen or acute external otitis. The results of studying the thermal characteristics of the body of water used for such aquatic activities is presented.

Adolescent↗
PubMed2000

EXT 1 gene mutation induces chondrocyte cytoskeletal abnormalities and defective collagen expression in the exostoses.

Hereditary multiple exostoses (HME), an autosomal skeletal disorder characterized by cartilage-capped excrescences, has been ascribed to mutations in EXT 1 and EXT 2, two tumor suppressor-related genes encoding glycosyltransferases involved in the heparan sulfate proteoglycan (HSPG) biosynthesis. Taking advantage of the availability of three different exostoses from a patient with HME harboring a premature termination codon in the EXT 1 gene, morphological, immunologic, and biochemical analyses of the samples were carried out. The cartilaginous exostosis, when compared with control cartilage, exhibited alterations in the distribution and morphology of chondrocytes with abundant bundles of actin filaments indicative of cytoskeletal defects. Chondrocytes in the exostosis were surrounded by an extracellular matrix containing abnormally high amounts of collagen type X. The unexpected presence of collagen type I unevenly distributed in the cartilage matrix further suggested that some of the hypertrophic chondrocytes detected in the cartilaginous caps of the exostoses underwent accelerated differentiation. The two mineralized exostoses presented lamellar bone arrangement undergoing intense remodeling as evidenced by the presence of numerous reversal lines. The increased electrophoretic mobility of chondroitin sulfate and dermatan sulfate proteoglycans (PGs) extracted from the two bony exostoses was ascribed to an absence of the decorin core protein. Altogether, these data indicate that EXT mutations might induce a defective endochondral ossification process in exostoses by altering actin distribution and chondrocyte differentiation and by promoting primary calcification through decorin removal.

Adolescent↗
PubMed1998

[Hereditary exostoses--presentation of a family case].

In this article we present a Norwegian family with hereditary multiple exostoses and a review of relevant literature. 21 family members were examined; ten males and six females had multiple exostoses, the youngest from six months of age. The exostoses had led to compression of nerves, disturbance of bone growth with shortening and bowing of the forearm bones, and valgus deformity of the knee and ankle. Physical function and quality of life was generally well preserved. Contrary to most reports, nearly half of the patients had allegedly noticed growth or debut of exostoses in adulthood. Almost half of the patients had had the exostoses removed surgically twice, (median value). Malignant transformation of exostoses has not been observed in the family.

Adolescent↗
PubMed1991

Behavior-induced auditory exostoses in imperial Roman society: evidence from coeval urban and rural communities near Rome.

Presence and features of auditory exostoses were investigated in two cranial samples of Roman imperial age (1st-3rd century A.D.). The skeletal material comes from the necropolises of Portus (Isola Sacra) and Lucus Feroniae (Via Capenate), two towns along the Tevere River, in close relation with the social and economic life of Rome. Deep-rooted differences between the human communities represented by the skeletal samples (83 and 71 individuals, respectively, in this study) are documented both historically and archaeologically. The results show lack of exostoses in the female sex, a negligible incidence among the males of Lucus Feroniae, but a high frequency in the male sample from Isola Sacra (31.3%). Auditory exostoses are commonly recognised as localized hyperplastic growths of predominantly acquired origin. Features of the exostoses found in the male crania from Isola Sacra (particularly in relation to the age at death of the affected individuals) support this view. Furthermore, several clinical and anthropological studies have pointed out close links between the occurrence of auditory exostoses and prolonged cold water exposure, generally due to the practice of aquatic sports, or to working activities involving water contact or diving. In this perspective, the differences observed between the two Roman populations and between the sexes (in Isola Sacra) appear to result from different social habits: the middle class population of Portus habitually used thermal baths, whereas it is probable that thermae were seldom frequented (if at all) by the Lucus Feroniae population represented in the necropolis (mostly composed by slaves or freedmen farm laborers).(ABSTRACT TRUNCATED AT 250 WORDS)

Baths↗
PubMed1996

A histopathologic review of temporal bone exostoses and osteomata.

It is widely accepted that external auditory canal exostoses and osteomata are separate clinical entities that differ in their gross appearance. Disagreement still exists as to whether external auditory canal exostoses and osteomata should be considered similar or separate histopathologic entities. A chart review was performed of all patients who had external auditory canal exostoses or temporal bone osteomata excised from January 1991 to November 1994 at St. Vincent's Hospital, Sydney. A histologic examination was undertaken with a blind study method of the patients whose pathological specimens were suitable for assessment. Eight exostoses and five osteomata were available for examination. The results of this study demonstrate that exostoses and osteomata of the external auditory canal cannot be reliably differentiated by routine histopathological examination.

Bone Neoplasms↗
PubMed1998

Treatment of external auditory canal exostoses.

Exostoses of the external auditory canal can occur in patients living in coastal, southern California communities with a history of cold-water aquatic activities such as ocean surfing and swimming. Although most canal exostoses are asymptomatic, patients with canal obstruction greater than 80% can have recurrent episodes of external otitis and a related conductive hearing loss. In most cases, medical treatment resolves the symptomatic external otitis and related hearing loss. Patients recalcitrant to medical treatment are candidates for surgical removal of the exostoses. This report reviews the authors' surgical experience with 18 patients (27 ears) who have undergone surgical removal of exostoses. Their preferred surgical technique of transmeatal removal of exostoses with a specialized mallet and thin chisel under local anesthesia is described.

Adult↗
PubMedDate not supplied

Impingement exostoses of the talus and fibula secondary to an inversion sprain. A case report.

Impingement exostoses of the talus and fibula following an inversion sprain is an uncommon sequela to the initial injury. Although a high frequency of symptomatic tibial and talar impingement exostoses have been reported, changes on the lateral side of the ankle are more subtle with significant roentgenographic findings rarely seen. The authors present a rare case of impingement exostoses involving both the talus and fibula simultaneously. Arthroscopy visualized the tibiotalar and talomalleolar articulations. It revealed opposing exostoses of the talus and fibula, necessitating surgical resection. Arthroscopy is recommended for difficult diagnostic problems of the ankle and an awareness of the condition of post-traumatic impingement exostoses of the talus and fibula.

Ankle Injuries↗