Surgical osteoplasty and soft tissue excision as treatment for facial deformities in patients with renal osteodystrophy: three case reports.

Autor: Junior LCM; Traumatology and Bucomaxillofacial Surgery Service, Departament of Dentistry, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN, CEP 59056-000, Brazil. Luizcarlosctbmf@gmail.com., de França GM; Oral Pathology postgraduate program, Federal University of Rio Grande do Norte, Natal, Brazil., Dantas WRM; Traumatology and Bucomaxillofacial Surgery, Federal University of Rio Grande do Norte, Natal, Brazil., Germano AR; Traumatology and Bucomaxillofacial Surgery, Federal University of Rio Grande do Norte, Natal, Brazil.
Jazyk: angličtina
Zdroj: Oral and maxillofacial surgery [Oral Maxillofac Surg] 2020 Jun; Vol. 24 (2), pp. 221-227. Date of Electronic Publication: 2019 Dec 12.
DOI: 10.1007/s10006-019-00819-5
Abstrakt: Background: Renal osteodystrophy (ROD) may occur in patients presenting chronic kidney disease (CKD), leading to laboratory test alterations and changes in bone turnover with extra-skeletal calcifications. Treatment involves the medical management of secondary hyperparathyroidism, potential total parathyroidectomy, and surgical interventions concerning calcifications if causing facial deformities with esthetic and functional repercussions. In this context, the aim of the present study is to describe three cases of facial deformities caused by ROD treated through cosmetic-functional surgeries.
Case Presentation: All patients underwent osteoplasty and soft tissue excision for several purposes, including speech difficulties, chewing difficulties, airway obstructions, malocclusion, and facial disharmony. Most patients were male (n = 2, 66.7%) with a mean age of 30.0 years old. Patients underwent a mean hemodialysis time of 9 years, and the maximum mean parathyroid hormone (PTH) level was of 2384.5 pg/ml.
Conclusions: Long hemodialysis periods and elevated PTH levels were the probable factors for the development of facial deformities in this group of patients. The main complications associated to the surgical management of facial deformities in ROD patients are directly related to end-stage renal disease, with increased risks for hemorrhage and systemic drug accumulation.
Databáze: MEDLINE
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