Department of Plastic and Reconstructive Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Eur J Endocrinol. 2021 Feb;184(2):231-241. doi: 10.1530/EJE-20-0962.
Facial abnormality is the most significant feature in acromegaly patients. However, it is unclear whether and how patient facial appearance improves after treatment. This study aimed to identify 3D facial changes in acromegaly patients after surgical treatment.
This study included 30 acromegaly patients who underwent resection of a pituitary GH adenoma. The location and extent of facial changes were identified by comparing baseline and 2-year follow-up 3D images of the face. Relationships between facial changes and GH and IGF-1 were evaluated with simple or multivariable linear regression models.
Significant soft tissue improvements were observed in acromegaly patients with complete remission, especially in the nose and lip region. Significant reductions in nasal width (3.46 mm, P < 0.001), tip protrusion (1.18 mm, P = 0.003), face curve length (3.89 mm, P = 0.004) and vermilion area (1.42 cm3, P = 0.001) were observed at the 2-year follow-up. Further, changes in nasal width were associated with decreases in GH (β = 4.440, P = 0.017), the GH nadir (β = 4.393, P = 0.011) and IGF-1 (β = 5.263, P = 0.002). The associations were maintained after adjusting for confounders.
Acromegaly patients achieved considerable facial improvements after surgical treatment. The change in nose width was associated with GH and IGF-1 decrease. Better control of patient hormone levels after surgery improves patient facial recovery.
面部异常是肢端肥大症患者最显著的特征。然而，目前尚不清楚患者的面部外观在治疗后是否以及如何改善。本研究旨在确定肢端肥大症患者接受垂体 GH 腺瘤切除术后的 3D 面部变化。
本研究纳入了 30 例接受垂体 GH 腺瘤切除术的肢端肥大症患者。通过比较基线和 2 年随访的面部 3D 图像，确定面部变化的位置和程度。使用简单或多变量线性回归模型评估面部变化与 GH 和 IGF-1 之间的关系。
完全缓解的肢端肥大症患者观察到明显的软组织改善，特别是在鼻子和嘴唇区域。鼻子宽度（3.46mm，P<0.001）、鼻尖突出度（1.18mm，P=0.003）、面部曲线长度（3.89mm，P=0.004）和唇红面积（1.42cm3，P=0.001）在 2 年随访时显著减小。此外，鼻宽的变化与 GH（β=4.440，P=0.017）、GH 谷值（β=4.393，P=0.011）和 IGF-1（β=5.263，P=0.002）的降低有关。在调整混杂因素后，相关性仍然存在。
肢端肥大症患者在接受手术治疗后面部得到了相当大的改善。鼻宽的变化与 GH 和 IGF-1 的降低有关。手术后患者激素水平得到更好的控制，可改善患者面部恢复。
