Simultaneous decompression of the orbital lateral wall and optic canal for fibrous dysplasia in early adolescence

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Abstract

Introduction: Patients with fronto-orbital fibrous dysplasia (FD) occasionally present fronto-orbital protrusion, exophthalmos, and visual acuity disturbance. Simultaneous management of these conditions has not been previously described. Case description: A-10-year-old female with fronto-orbital FD complained of left visual acuity disturbance. Head computed tomography showed compressed optic canal secondary to thickened bone. Decompression of the optic canal via the left frontotemporal extradural approach, opening of the lateral orbital wall, and dissection of the prominent zygoma were done simultaneously. The patient’s visual acuity disturbance and exophthalmos subsequently improved postoperatively. Discussion and evaluation: When optic canal decompression is performed by the fronto-temporal approach, opening of the lateral orbital wall can be done simultaneously to decrease the intraorbital pressure and to prevent exophthalmos. In addition, although aesthetic plastic surgery is not generally recommended during the growing phase (due to the possibility of recurrence), this approach can prevent skin loosening and adverse cosmetic outcomes. Conclusions: Aesthetic plastic surgery for fronto-orbital FD is recommended to prevent skin loosening. Opening of the lateral orbital wall should be performed when optic canal decompression is planned.

Original languageEnglish
Article number719
JournalSpringerPlus
Volume5
Issue number1
DOIs
Publication statusPublished - 2016 Dec 1

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Plastic Surgery
Decompression
Exophthalmos
Visual Acuity
Patient Acuity
Zygoma
Skin
antineoplaston A10
Cosmetics
Dissection
Head
Tomography
Pressure
Bone and Bones
Recurrence

Keywords

  • Early adolescence
  • Fibrous dysplasia
  • Optic canal
  • Orbital lateral wall

ASJC Scopus subject areas

  • General

Cite this

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title = "Simultaneous decompression of the orbital lateral wall and optic canal for fibrous dysplasia in early adolescence",
abstract = "Introduction: Patients with fronto-orbital fibrous dysplasia (FD) occasionally present fronto-orbital protrusion, exophthalmos, and visual acuity disturbance. Simultaneous management of these conditions has not been previously described. Case description: A-10-year-old female with fronto-orbital FD complained of left visual acuity disturbance. Head computed tomography showed compressed optic canal secondary to thickened bone. Decompression of the optic canal via the left frontotemporal extradural approach, opening of the lateral orbital wall, and dissection of the prominent zygoma were done simultaneously. The patient’s visual acuity disturbance and exophthalmos subsequently improved postoperatively. Discussion and evaluation: When optic canal decompression is performed by the fronto-temporal approach, opening of the lateral orbital wall can be done simultaneously to decrease the intraorbital pressure and to prevent exophthalmos. In addition, although aesthetic plastic surgery is not generally recommended during the growing phase (due to the possibility of recurrence), this approach can prevent skin loosening and adverse cosmetic outcomes. Conclusions: Aesthetic plastic surgery for fronto-orbital FD is recommended to prevent skin loosening. Opening of the lateral orbital wall should be performed when optic canal decompression is planned.",
keywords = "Early adolescence, Fibrous dysplasia, Optic canal, Orbital lateral wall",
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AU - Miwa, Tomoru

AU - Sakamoto, Yoshiaki

AU - Kohno, Maya

AU - Kishi, Kazuo

AU - Yoshida, Kazunari

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N2 - Introduction: Patients with fronto-orbital fibrous dysplasia (FD) occasionally present fronto-orbital protrusion, exophthalmos, and visual acuity disturbance. Simultaneous management of these conditions has not been previously described. Case description: A-10-year-old female with fronto-orbital FD complained of left visual acuity disturbance. Head computed tomography showed compressed optic canal secondary to thickened bone. Decompression of the optic canal via the left frontotemporal extradural approach, opening of the lateral orbital wall, and dissection of the prominent zygoma were done simultaneously. The patient’s visual acuity disturbance and exophthalmos subsequently improved postoperatively. Discussion and evaluation: When optic canal decompression is performed by the fronto-temporal approach, opening of the lateral orbital wall can be done simultaneously to decrease the intraorbital pressure and to prevent exophthalmos. In addition, although aesthetic plastic surgery is not generally recommended during the growing phase (due to the possibility of recurrence), this approach can prevent skin loosening and adverse cosmetic outcomes. Conclusions: Aesthetic plastic surgery for fronto-orbital FD is recommended to prevent skin loosening. Opening of the lateral orbital wall should be performed when optic canal decompression is planned.

AB - Introduction: Patients with fronto-orbital fibrous dysplasia (FD) occasionally present fronto-orbital protrusion, exophthalmos, and visual acuity disturbance. Simultaneous management of these conditions has not been previously described. Case description: A-10-year-old female with fronto-orbital FD complained of left visual acuity disturbance. Head computed tomography showed compressed optic canal secondary to thickened bone. Decompression of the optic canal via the left frontotemporal extradural approach, opening of the lateral orbital wall, and dissection of the prominent zygoma were done simultaneously. The patient’s visual acuity disturbance and exophthalmos subsequently improved postoperatively. Discussion and evaluation: When optic canal decompression is performed by the fronto-temporal approach, opening of the lateral orbital wall can be done simultaneously to decrease the intraorbital pressure and to prevent exophthalmos. In addition, although aesthetic plastic surgery is not generally recommended during the growing phase (due to the possibility of recurrence), this approach can prevent skin loosening and adverse cosmetic outcomes. Conclusions: Aesthetic plastic surgery for fronto-orbital FD is recommended to prevent skin loosening. Opening of the lateral orbital wall should be performed when optic canal decompression is planned.

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KW - Optic canal

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