The Skull

Lesions in the skull, although reported are extremely rare. Mandibular osteochondromas, typically of the condyle, skull wall lesions and even intracranial lesions have been reported.


Affects of MHE on Skull

  • Exostoses can cause problems if they compress or entrap cranial nerves or cause extrinsic compression on the brain. Effects can range from bumpy external lesions that cause cosmetic problems, compression of adjacent structures, cranial nerve involvement and even focal neurological deficits due to compression. Even seizures are likely due to intracranial lesions.



Diagnostic Procedures

  • The orthopedist will manually feel for exostoses along the outer table of the skull, check movements of the mandible and also of the upper cervical spine. The orthopedist will also check cranial nerve function and perform a thorough neurological evaluation. X-rays or other imaging tests including CT and MRI may be ordered.

Possible Treatment Options

  • Minor lesions on the outer table of the skull that are flat can sometimes be closely observed.

  • Bigger lesions on the skull, mandibular lesions causing TM joint instability, and intracranial lesions causing pressure signs may need to be removed by neurosurgical intervention.

  • Upper cervical spinal tumors, especially of the atlanto-occipital region may be dealt with by orthopedists. Decompression and or stabilization may be performed as required.


What Parents Should Watch Out For

  • Pain.  Is your child experiencing pain from exostoses?

  • Visible lumps on the face or skull.

  • Any symptoms of tingling, numbness, weakness in the hands or legs suggestive of focal deficits.

  • Episodes of seizures or findings of cranial nerve involvement like altered smell, taste, ringing in ears etc.

  • Problems in chewing, restricted motion of the jawbone or instability of the mandible.

  • Parents can ask dentists and orthodontists to be on the lookout for signs suggestive of jawbone instability or joint involvement during their office visits especially in symptomatic cases.

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