Journal of Oral and Maxillofacial Surgery, 59(2), 157–167 (2001), DOI:10.1053/joms.2001.20487
Purpose: Craniofacial fibrous dysplais (CFD),involving the fronto-orbital region often is challenging to treatbecause of the proximity of neurovascular and ocular structures. Thisarticle presents the surgical experience with 6 patients.
Patients and Methods:Six patients ranging in age from 7 to 23 years, who had undergonesurgery for CFD of the orbital region, were retrospectively reviewed.All patients had progressive complaints of deformity, pain, paresthesiaor visual disturbances. Surgery generally involved extensive tumorexcision and immediate orbital reconstruction with autogenous bonegrafts. Two patients also were reconstructed with resected and treatedautogenous bone, which then was immediately reimplanted, using rigidfixation. Three patients also had intracranial microsurgical opticcanal decompression. All patients received perioperativecorticosteroids.
Results: Five patients experiencedpartial relief of their sensory and visual disturbances. These patientsalso felt that there had been improvement in facial appearance. Onepatient with very extensive circumferential optic canal involvement,and who underwent 2-wall decompression, suffered visual loss.
Conclusion:Early surgery to address progressive sensory disturbances isrecommended so as to avoid the hazards of late-stage decompression. Therisks of surgery must be weighed against the benefits of achieving amore functional and aesthetic result. Long-term neuro-ophthalmologicmonitoring is essential.