A lateral approach at the upper corner of the orbit in fronto-orbital fibrous dysplasia: less invasive and more effective approach for morphologic reconstruction and optic functional restoration.

OBJECTIVE

To explore the concise surgical approach to treat complicated intracranio- and extracranio-orbital fibrous dysplasia.

METHODS

A lateral approach started at the upper corner of the orbit was used in subtotal resection of fronto-orbital fibrous dysplasia, involving the frontal, orbital, sphenoid, and temporal bones. Subtotal lesion removal and optic nerve decompression were performed after unilateral frontotemporal craniotomy. Reshaping of the frontotemporal bone flap was then carried out for replacing to gain better shape of the fronto-orbital region. Radiological examinations and visual functional evaluations were conducted before and after the operation.

RESULTS

In our series of 21 cases, better fronto-orbital contour has been received, except 1 case of relapse in a teenager. The follow-up period ranged from 9 months to 3 years. Improvement in visual function was obtained in 19 cases of vision impairment.

CONCLUSION

Lateral approach that starts at the upper orbital rim and temporal fossa is a concise approach in correction of fronto-orbital fibrous dysplasia.