Leontiasis Ossea

Abstract

Leontiasis is a generic rather than a specific term, covering a widely varying group of pathological conditions, all of which are said to produce a “lion-like” deformity of the features. The name has been applied to lesions whose ætiologies are poles apart, such as nodular leprosy and molluscum fibrosum, when these happen to involve the soft tissues of the face. If, however, the facial deformity is the result of change in the underlying bone, the slightly restricted term of Leontiasis Ossea is applicable. Here again difficulties of nomenclature arise, as under the heading of Leontiasis Ossea there have been described, localised manifestations of such generalised conditions as osteitis fibrosa, and rare instances of Paget's disease involving the mandible and facial bones. There is, however, a further type of cranial hyperostosis, which remains localised in skull and mandible, and shows no signs of being a generalised disease. This latter type customarily begins in youth, is of long duration, and only produces symptoms by secondary pressure on important structures or by the blockage of natural passages. The ætiology is not definitely known, but Knaggs (1923) has suggested that it is a creeping periosteitis originating from the maxillary antrum, or from dental sepsis. What follows refers exclusively to this type of leontiasis ossea, and the use of the term will be restricted to this very chronic localised disease of the facial bones.