Papay F A, Morales L, Flaharty P, Smith S J, Anderson R, WAlker J M, Hood R S, Hardy S
J Craniofac Surg. 1995 Jan;6(1):5-10; discussion 11-4. doi: 10.1097/00001665-199501000-00004.
Fibrous dysplasia of the anterior cranial base involves the bony orbit and optic canal. Although fibrous dysplasia is benign, it may produce a mass effect along the course of the optic nerve, inducing visual disturbances. Optic canal decompression in patients without clinical signs of optic neuropathy is controversial. We describe five patients with extensive fibrous dysplasia of the anterior cranial base involving the orbit and optic canal. These patients underwent transcranial optic canal decompression before signs of severe visual loss during correction of dystopias and craniofacial deformity induced by fibrous dysplasia. Cranial orbital reconstruction was performed by means of split rib and cranial bone grafts. Postoperative follow-up did not reveal disturbances in visual function, extraocular motility, or evidence of cerebrospinal fluid fistulas. This suggests that early, radical resection of orbital fibrous dysplasia with optic canal decompression may be effective in preventing visual loss with minimal risk of other neurological sequelae. Subsequent orbital reconstruction involving split-thickness rib and cranial bone grafting yields satisfactory cosmetic results.
前颅底骨纤维异常增殖症累及眼眶和视神经管。虽然骨纤维异常增殖症是良性的，但它可能沿视神经走行产生占位效应，导致视觉障碍。对于没有视神经病变临床体征的患者，进行视神经管减压存在争议。我们描述了5例前颅底广泛骨纤维异常增殖症累及眼眶和视神经管的患者。这些患者在纠正由骨纤维异常增殖症引起的眼球异位和颅面畸形过程中，在出现严重视力丧失迹象之前接受了经颅视神经管减压术。通过劈开肋骨和颅骨移植进行颅眶重建。术后随访未发现视觉功能、眼球运动障碍或脑脊液漏的证据。这表明早期彻底切除伴有视神经管减压的眼眶骨纤维异常增殖症可能有效地预防视力丧失，且其他神经后遗症风险最小。随后采用分层肋骨和颅骨移植进行眼眶重建可获得满意的美容效果。
