Bertin H, Huon J-F, Guillot P, Longis J, Corre P, Bordereau S, Lebranchu P
Service de Chirurgie maxillo-faciale, Centre Hospitalier Universitaire de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France; Laboratoire des sarcomes osseux et remodelage des tissus calcifiés (PhyOs, UMR 1238), faculté de médecine, 1, rue Gaston-Veil, 44035 Nantes cedex, France.
Service de pharmacie Clinique, Centre Hospitalier Universitaire de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France.
J Fr Ophtalmol. 2020 Jun;43(6):467-476. doi: 10.1016/j.jfo.2019.10.012. Epub 2020 May 4.
Fibrous dysplasia (FD) is a benign fibro-osseous developmental disorder of growing bone, sometimes involving the craniofacial skeleton (CFD). We wish to present a patient series with CFD of the orbital region and discuss treatment modalities.
Twelve patients were referred for orbital CFD in the Nantes University Hospital between 2000 and 2018 and studied according to the clinical parameters, radiological features, and modalities of treatment.
The mean age was 25.6 years. Ten patients exhibited facial asymmetry with vertical globe dystopia (75%), proptosis (58%) and facial bump (50%). The disease was monostotic in 83% of patients, involving the frontal bone (25%), the sphenoidal bone (33%), the fronto-sphenoidal complex (25%), and the skull base (17%). Unilateral radiological proptosis was found in 7 patients, with a mean protrusion 3.9mm. The optic canal was involved in 75% of patients, with no functional impairment. Three patients were treated with bisphosphonate therapy to stop progression of the disease; 6 patients were given a bone remodelling procedure with good aesthetic outcomes.
The orbit is a rare localization for FD causing aesthetic and functional disabilities. Medical and surgical treatment can be proposed as part of a multidisciplinary approach.
骨纤维异常增殖症(FD)是一种发生于生长中骨骼的良性纤维-骨发育障碍性疾病,有时会累及颅面骨骼(CFD)。我们希望展示一组眶区CFD患者病例并讨论治疗方式。
2000年至2018年间,12例患者因眶区CFD转诊至南特大学医院,并根据临床参数、放射学特征和治疗方式进行研究。
平均年龄为25.6岁。10例患者表现出面部不对称,伴有垂直性眼球异位(75%)、眼球突出(58%)和面部肿块(50%)。83%的患者为单骨型病变,累及额骨(25%)、蝶骨(33%)、额-蝶复合体(25%)和颅底(17%)。7例患者存在单侧放射学上的眼球突出,平均突出度为3.9mm。75%的患者视神经管受累,但无功能损害。3例患者接受双膦酸盐治疗以阻止疾病进展;6例患者接受了骨重塑手术,美学效果良好。
眶区是FD的罕见发病部位,可导致美学和功能障碍。可作为多学科方法的一部分提出药物和手术治疗方案。