Introduction: Traumatic brain injury (TBI) is a worldwide public health problem and has been recently documented as a cause of neuroendocrine dysfunction. It has been shown that hypopituitarism may develop nearly 1020% of the TBI patients, and most common pituitary hormone deficiency after TBI is growth hormone deficiency (GHD). To date no study has evaluated the relation between isolated maxillofacial fractures and pituitary dysfunction. Therefore we aimed to investigate pituitary function in patients with traumatic maxillofacial fracture.
Methods and results: Thirty patients who had traumatic maxillofacial fracture at least 12 months ago (mean 33.6 months) were included in the study retrospectively. Twenty-six of 30 patients (86.7) were male and 4 patients (13.3%) were female, and mean age of the study group was 39.8 years (range; 1863). None of the patients had loss of consciousness after head trauma and they did not hospitalized in intensive care unit.
The type of maxillofacial fractures were as follows: One patient had blow out, seven patients had Lefort 12, six patients had mandibula, three patients had nasal and thirteen patients had zygoma fractures. Basal hormone levels, Glucagon and 1 mcg ACTH stimulation tests were performed to investigate the pituitary functions. Four of 30 patients (13.3%) had isolated GH deficiency based on glucagon stimulation test (GST). Mean peak GH level after GST in patients with hypopituitarism (0.43 ng/ml) was significantly lower than the patients without hypopituitarism (6.7 ng/ml). Other anterior pituitary hormones were normal in all patients, and none of them had diabetes insipidus.
Conclusion: These preliminary results suggest that there is a substantial risk for hypopituitarism, GH deficiency in particular, during the chronic phase of traumatic maxillofacial fractures. However these findings need confirmation with further prospective studies with higher number of patients.