TY - JOUR
T1 - Long-term outcome of fibrous dysplasia
T2 - Reconstruction with dysplastic bone
AU - Sakamoto, Yoshiaki
AU - Nakajima, Hideo
AU - Tamada, Ikkei
AU - Kishi, Kazuo
AU - Kawase, Takeshi
N1 - Funding Information:
ACNOWLEDGEMENTS The study made use of facilities in several university departments, and the Authors wish to express sincere gratitude for the generous assistance they received. In particular they thank Professor G. S. Boulton and G. Angell, Department of Geology, University of Edinburgh, for the XRD; Dr J. Jarvis and C. Cameron, Departments of Geology and Geography, University of St Andrews, for the SediGraph and HPLC; Dr R. N. Hunter (Department of Chemistry, Heriot-Watt University) for the AAS; Dr G. C. Sills, Department of Engineering Science, University of Oxford for the X-ray densitometry; Dr P. Smart and P. Ainsworth, Departments of Civil Engineering and of Geology, University of Glasgow, for the SEM; and Dr N. K. Tovey, School of Environmental Sciences, University of East Anglia, for the SEM preparation. Sample collection was undertaken by the Building Research Establishment, and J. J. M. Powell is thanked for his advice and assistance. Field and laboratory work was undertaken by H. Barras to whom many thanks are due. The generous advice of many other colleagues is gratefully acknowledged. Gratitude is expressed to the SERC for financial assistance.
PY - 2011/12/25
Y1 - 2011/12/25
N2 - A 10-year-old girl presented with facial asymmetry associated with bulging of the right fronto-orbital region with no symptoms. Computed tomography demonstrated enlargement of the right zygomatic, frontal, ethmoid, and sphenoid bones. Abnormal proliferation of the bone had obliterated the sphenoid, right frontal sinus, and right ethmoid sinuses. These radiological findings suggested right optic nerve compression due to fibrous dysplasia. Right optic canal decompression was performed. In preparation for recurrence, the resulting bone defect in the right orbital roof was reconstructed using the outer table of the split lesion bone. The removed frontal bone was divided into intact and lesioned parts, and the intact part was returned. The lesioned part was split and the outer table graft used to reconstruct the frontal region. A temporal musculopericranial flap was used to form a barrier between the opened ethmoid sinus and cranial cavity. A protrusion appeared on the left forehead 10 years later, and was shaved to improve the aesthetic appearance. The patient was followed up for a total of 23 years. The use of dysplastic bone involves the risk of recurrence, but the period of recurrence is delayed and the progression stops after adolescence, so the second operation involved only shaving for aesthetic appearance. This procedure is one of the treatments of choice because of easy reconstruction, easy revision, and good results.
AB - A 10-year-old girl presented with facial asymmetry associated with bulging of the right fronto-orbital region with no symptoms. Computed tomography demonstrated enlargement of the right zygomatic, frontal, ethmoid, and sphenoid bones. Abnormal proliferation of the bone had obliterated the sphenoid, right frontal sinus, and right ethmoid sinuses. These radiological findings suggested right optic nerve compression due to fibrous dysplasia. Right optic canal decompression was performed. In preparation for recurrence, the resulting bone defect in the right orbital roof was reconstructed using the outer table of the split lesion bone. The removed frontal bone was divided into intact and lesioned parts, and the intact part was returned. The lesioned part was split and the outer table graft used to reconstruct the frontal region. A temporal musculopericranial flap was used to form a barrier between the opened ethmoid sinus and cranial cavity. A protrusion appeared on the left forehead 10 years later, and was shaved to improve the aesthetic appearance. The patient was followed up for a total of 23 years. The use of dysplastic bone involves the risk of recurrence, but the period of recurrence is delayed and the progression stops after adolescence, so the second operation involved only shaving for aesthetic appearance. This procedure is one of the treatments of choice because of easy reconstruction, easy revision, and good results.
KW - Autogenous graft
KW - Craniofacial surgery
KW - Dysplastic bone
KW - Fibrous dysplasia
KW - Reconstruction
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UR - http://www.scopus.com/inward/citedby.url?scp=84455181447&partnerID=8YFLogxK
U2 - 10.2176/nmc.51.857
DO - 10.2176/nmc.51.857
M3 - Article
C2 - 22198111
AN - SCOPUS:84455181447
VL - 51
SP - 857
EP - 860
JO - Neurologia Medico-Chirurgica
JF - Neurologia Medico-Chirurgica
SN - 0470-8105
IS - 12
ER -