Hiperostoza frontalne kosti kod muškaraca: makro i mikro morfološke promene kostiju

Hyperostosis frontalis interna (HFI) is an idiopathic condition manifested by bone formation involving the endocranial surface of the frontal bone. A low androgen level seems to be an important correlating factor for the origin of the condition in males, while in females the correlation seems to be more complex. If hormonal imbalance was to be considered a probable cause of HFI occurrence, it would be expected that changes in hormonal levels would have some systemic effect, especially affecting the skeletal system. Aim: To compare macroscopic and microarchitectural morphology between male and female skulls with different types of HFI, whether frontal bone formation accompanies changes in bone structure in a systemic manner and could HFI be used as an additional criterion for sex and age estimation of the skeletal remains. Materials and methods: The first part was an observational, cross-sectional autopsy study where the sample was taken from human donor cadavers and divided into four groups: males with and without HFI and females with and without HFI. We analyzed age distribution, macroscopic appearance of HFI and morphological features (thickness of the frontal, temporal and occipital bones and longitudinal and frontal diameters of the skulls) of the male skulls with HFI and compared the results with female skulls with this condition. The second study was carried out on selected, age-matched subjects. The specimens of the frontal and femoral bones were collected and scanned using microcomputed tomography and dual energy x-ray absorptiometry (DXA). Parameters of hip structure analysis were calculated from data derived from DXA scans. Results: Males are younger at the time of HFI occurrence and show the same risk of having this condition as females less than 55 years of age. They most commonly have milder forms of HFI. Females have almost four times greater chances of developing the most severe HFI type. Bone formation is most pronounced on the frontal bone;however, other skull bones are affected as well. In males, HFI does not affect cranial vault size and in females the longitudinal diameter of the skull is slightly decreased...Hiperostoza frontalne kosti (lat. hyperostosis frontalis interna – HFI) predstavlja zadebljanje unutrašnje ploče frontalne kosti čiji je uzrok nepoznat. Izgleda da je kod muškaraca nizak nivo androgena važan faktor u nastanku HFI, dok je kod žena hormonski uticaj složeniji. Ako HFI zaista nastaje usled hormonske neravnoteže, očekivano je da promene koncentracija hormona imaju uticaja i na drugim mestima u organizmu, što bi se posebno odrazilo na koštani sistem. Cilj: Uporediti makroskopsku morfologiju i mikroarhitekturu muških i ženskih lobanja sa različitim stadijumima HFI, utvrditi da li zadebljanje čeone kosti prati sistemska promena strukture kostiju i da li se HFI može koristiti kao dodatni kriterijum za procenu pola i starosti skeletnih ostataka. Materijal i metode: Prvi deo istraživanja je opservaciona, autopsijska studija preseka spovedena na kadaveričnom materijalu koji je podeljen u četiri grupe: muškaraci sa i bez HFI i žene sa i bez HFI. Analizirali smo starosnu distribuciju, makroskopske i morfološke karakteristike lobanja (debljinu frontalne, temporalne i okcipitalne kosti, uzdužni i poprečni dijametar) muškaraca sa HFI i upoređivali ih sa lobanjama žena sa HFI. Drugi deo istraživanja sproveden je na odbranim slučajevima iz prethodnog uzorka, koji su upareni po starosti. Uzimani su uzorci frontalne i butne kosti i analizirani korišćenjem mikrokompjuterizovane tomografije i dvoenergetske rendgenske apsorcimetrije (DXA). Parametri strukturne analize izračunati su iz podataka dobijenih DXA analizom. Rezultati: U momentu nastanka HFI, muškarci sa mlađi od žena, a njihov rizik da imaju ovo stanje je isti kao i kod žena mlađih od 55 godina. Muškarci najčešće imaju blaže stadijume HFI. Žene imaju skoro četiri puta veću šansu da ispolje najteži stadijum HFI. Koštano zadebljanje je najizraženije na frontalnoj kosti kod svih osoba sa HFI, međutim, ostale kosti lobanje su takođe zahvaćene procesom. Kod muškaraca, HFI ne utiče na zapreminu lobanjske duplje, dok je kod žena sa HFI uzdužni dijametar lobanje lako smanjen. Mikroarhitektura frontalne kosti sa HFI je ista u oba pola..