Acromegaly / by Maximilian Sternberg ; translated by F.R.B. Atkinson.

  • Sternberg, Maximilian, 1863-
Date:
[1899]
Catalogue details

Licence: Public Domain Mark

Credit: Acromegaly / by Maximilian Sternberg ; translated by F.R.B. Atkinson. Source: Wellcome Collection.

    28/186 (page 24)
    ACROMEGALY. of tlie tipper jaw, malars, &c., increase the length of the face, and produce the long oval face which most patients with acromegaly possess (especially well marked in Fig. 4). The hypertrophy of the bones of the base of the daill causes contraction, as a rule, of the nerve foramina. The optic foramina especially are laterally compressed, oval or angular. The narrowing is hardly ever sufficient to produce serious damage to the nerves. The alterations in the temporal hones are important on account of their relationship to the ear. Owing to the swell- ing of the mastoid process, the osseous portion of the aque- ductus vestibuli is lengthened and narrowed. Small ex- ostoses in the wall still further injure the duct. The sphenoid bone shows very varied conditions. Tu a small number of cases there exists no enlargement of the hypophysis, and consequently the pituitary fossa is found noimal. In other cases, with relatively smaller uniform and slowly growing tumours of the hj'pophysis, the sella Tuicica is widened in every direction. The suiTounding bones are partly displaced, partly atrophied ^ Thus the dorsum sellee is bent backwards and much thinned, the clinoid processes disappear. In the same way, the tuber- culum sellce Turcicee and the middle clinoid processes dis- appeai. The floor of the sella Turcica is bulged downwards, so that the sphenoidal sinuses are much diminished in size: at the same time it becomes like paper, and is often perforated in several jflaces. If the tumour grows more markedly downwaids, the thin plate of bone, Avhich se])arates the pituitary fossa from the sphenoidal sinuses, becomes quite consumed. In most cases then the surrounding walls of bone gi\e way on all sides to the pressure of the tumour and the bone is everywhere destroyed, something similar to the ster- num and ribs before a forward growing aortic aneurysm. It may also attack the pharyngeal wall of the sphenoidal sinuses, so that of the whole body of the sphenoid only small thin trabeculre of boiie remain, which surround the fused jntuitary fossa and sphenoidal sinuses. A similar condition is found if the tumour of the hypojDhysis directly infiltrates the bone. I he growth then proceeds f[uite irregularly, the 8])henoid is destroyed in the mqst varied manner, partly by