Orbito-cranial Reconstruction and Unilateral Optic Canal Release in a Patient with Left Fronto-orbital Fibrous Dysplasia:A case report Toshiyuki NANAMI 1 , Tetsuo HIDAKA 1 , Jun KIDOGUCHI 1 , Akira OGAWA 1 1Department of Neurosurgery, Iwate Medical University Keyword: Fibrous dysplasia , Optic canal stenosis , Orbito-cranial reconstruction pp.967-971
Published Date 1994/10/10
DOI https://doi.org/10.11477/mf.1436900921
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A surgical case of monostotic fibrous dysplasia of the left frontal and sphenoidal bone in a 14-year-old girl is described.

This girl was admitted to our hospital in March, 1992, with a chief complaint of facial deformity and asymmetry due to a painless and progressive bony bulging over the left fronto-orbital region. But she de-nied any symptoms such as proptosis, diplopia, optic atrophy and visual loss. Other data found on neurolo-gical examination and laboratory tests were normal. In addition, she had no history of skin lesions, precocious puberty or other endocrine abnormalities.

Plain craniogram showed remarkable thickening of the left frontal bone and of the anterior cranial fossa of the sphenoidal bone with irregular stenosis of the left optic canal. CT scan showed the diffuse enlargement of the affected bone and involvement of the paranasal sinuses. Angiography revealed no positive findings. On December 10, 1992, orbito-cranial reconstruction and unilateral optic canal release were performed using an extradural approach through a left fronto-temporal cra-nietomy.

Histological fingings confirmed the lesion to be typic-al fibrous dysplasia. She recovered completly one month after the operation, but she suffered transient blurred vision, diplopia and left ptosis. Most of the decreased vision caused by fibrous dys-plasia cannot be reversed after surgical treatment. So, if optic canal stenosis is evident, even when visual loss is not clear, release of the optic canal stenosis should be done as early as possible in association with experi-enced neurosurgeons and with meticulous dissection.

Copyright © 1994, Igaku-Shoin Ltd. All rights reserved.


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