Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Department of Neurosurgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Medical Augmented Reality Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.
World Neurosurg. 2020 Nov;143:389-391. doi: 10.1016/j.wneu.2020.07.167. Epub 2020 Jul 31.
Fibrous dysplasia (FD) is a benign, slowly progressive disease resulting from the replacement of normal bone by fibro-osseous tissue. The incidence of craniofacial involvement of FD is as high as 23%. Sinonasal involvement of FD may lead to obstruction of the natural sinus ostium, resulting in acute sinusitis. We present a rare case of sinonasal FD complicated by subperiosteal abscess that was removed by bicoronal incision and frontal-basal approach in the second surgery.
A 16-year-old male patient presented with painful swelling on his left eye that had persisted for 2 days. Transnasal endoscopic drainage of the left orbital subperiosteal abscess was performed and progressive improvement of the swelling of the left eye was noted. After the acute phase, transcranial removal of the sinonasal bony lesion and mesh reconstruction of the left orbital wall were performed. There has been no progression of FD to date, with 24 months of follow-up.
After the acute phase, radical excision with reconstruction or debulking surgery after skeletal maturation may prevent recurrence. Although malignant transformation is rare, long-term follow-up is necessary for FD.
纤维结构不良（FD）是一种良性、进展缓慢的疾病，由纤维骨性组织替代正常骨。FD 颅面受累的发生率高达 23%。FD 累及鼻窦可导致自然窦口阻塞，从而引发急性鼻窦炎。我们报告了一例罕见的 FD 累及鼻窦并伴有骨膜下脓肿的病例，该病例在第二次手术中通过冠状切口和额底入路切除。
一名 16 岁男性患者因左眼疼痛性肿胀持续 2 天就诊。对左侧眼眶骨膜下脓肿进行了经鼻内镜引流，左眼肿胀逐渐改善。急性期过后，行颅面骨病变切除术和左侧眶壁网孔重建术。截至目前，FD 无进展，随访 24 个月。
在急性期过后，在骨骼成熟后进行根治性切除加重建或减瘤手术可能可以预防复发。虽然恶性转化罕见，但仍需要对 FD 进行长期随访。
