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Skull Base. 2002 August; 12(3): 145–152.
PMCID: PMC1656939

Optic Nerve Decompression for Orbitofrontal Fibrous Dysplasia


Orbitofrontal fibrous dysplasia often involves the bony orbit and the optic canal. Although fibrous dysplasia reportedly produces compression of the optic nerve leading to visual distrubances, optic nerve decompression in patients without clinical signs of optic neuropathy is still controversial. We describe two patients with orbitofrontal fibrous dysplasia without signs of visual disturbance and one patient with McCune-Albright syndrome and progressive visual impairment. Optic nerve decompression was performed prophylactically for two patients and therapeutically for one patient through the transcranial extradural route. Dystopias and craniofacial deformities induced by fibrous dysplasia also were corrected. The micropressure suction-irrigation system was especially effective for decreasing heat transfer and thereby preventing thermal injury of the optic nerve. The orbitofrontal area was reconstructed from cranial bone, iliac bone, and ribs. Postoperative follow-up revealed no disturbances in visual function and no evidence of cerebrospinal fluid leakage. These findings suggest that optic nerve decompression may be effective in preventing visual disturbances with minimal risk of other neurological sequelae. Subsequent orbital reconstruction yielded satisfactory cosmetic results.

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Selected References

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  • Chen YR, Breidahl A, Chang CN. Optic nerve decompression in fibrous dysplasia: indications, efficacy, and safety. Plast Reconstr Surg. 1997 Jan;99(1):22–33. [PubMed]
  • Liakos GM, Walker CB, Carruth JA. Ocular complications in craniofacial fibrous dysplasia. Br J Ophthalmol. 1979 Sep;63(9):611–616. [PMC free article] [PubMed]
  • Papadopoulos MC, Casey AT, Powell M. Craniofacial fibrous dysplasia complicated by acute, reversible visual loss: report of two cases. Br J Neurosurg. 1998 Apr;12(2):159–161. [PubMed]
  • Edgerton MT, Persing JA, Jane JA. The surgical treatment of fibrous dysplasia. With emphasis on recent contributions from cranio-maxillo-facial surgery. Ann Surg. 1985 Oct;202(4):459–479. [PubMed]
  • Katz BJ, Nerad JA. Ophthalmic manifestations of fibrous dysplasia: a disease of children and adults. Ophthalmology. 1998 Dec;105(12):2207–2215. [PubMed]
  • Sassin JF, Rosenberg RN. Neurological complications of fibrous dysplasia of the skull. Arch Neurol. 1968 Apr;18(4):363–369. [PubMed]
  • HARRIS WH, DUDLEY HR, Jr, BARRY RJ. The natural history of fibrous dysplasia. An orthopaedic, pathological, and roentgenographic study. J Bone Joint Surg Am. 1962 Mar;44-A:207–233. [PubMed]
  • LEEDS N, SEAMAN WB. Fibrous dysplasia of the skull and its differential diagnosis. A clinical and roentgenographic study of 46 cases. Radiology. 1962 Apr;78:570–582. [PubMed]
  • Lüdecke DK, Treige W. Pressure-irrigation-suction system. Technical note. Acta Neurochir (Wien) 1982;66(1-2):123–126. [PubMed]
  • Papay FA, Morales L, Jr, Flaharty P, Smith SJ, Anderson R, WAlker JM, Hood RS, Hardy S. Optic nerve decompression in cranial base fibrous dysplasia. J Craniofac Surg. 1995 Jan;6(1):5–14. [PubMed]
  • Weisman JS, Hepler RS, Vinters HV. Reversible visual loss caused by fibrous dysplasia. Am J Ophthalmol. 1990 Sep 15;110(3):244–249. [PubMed]
  • Kurokawa Y, Sohma T, Tsuchita H, Kitami K, Suzuki S, Sohma K. Hemorrhage into fibrous dysplasia following minor head injury--effective decompression for the ophthalmic artery and optic nerve. Surg Neurol. 1989 Dec;32(6):421–426. [PubMed]
  • Bland LI, Marchese MJ, McDonald JV. Acute monocular blindness secondary to fibrous dysplasia of the skull: a case report. Ann Ophthalmol. 1992 Jul;24(7):263–266. [PubMed]
  • Saito K, Suzuki Y, Nehashi K, Sugita K. Unilateral extradural approach for bilateral optic canal release in a patient with fibrous dysplasia. Surg Neurol. 1990 Aug;34(2):124–128. [PubMed]
  • Michael CB, Lee AG, Patrinely JR, Stal S, Blacklock JB. Visual loss associated with fibrous dysplasia of the anterior skull base. Case report and review of the literature. J Neurosurg. 2000 Feb;92(2):350–354. [PubMed]
  • Osguthorpe JD, Gudeman SK. Orbital complications of fibrous dysplasia. Otolaryngol Head Neck Surg. 1987 Oct;97(4):403–405. [PubMed]
  • Chen YR, Fairholm D. Fronto-orbito-sphenoidal fibrous dysplasia. Ann Plast Surg. 1985 Sep;15(3):190–203. [PubMed]
  • Chen YR, Noordhoff MS. Treatment of craniomaxillofacial fibrous dysplasia: how early and how extensive? Plast Reconstr Surg. 1990 Nov;86(5):835–844. [PubMed]
  • Finney HL, Roberts TS. Fibrous dysplasia of the skull with progressive cranial nerve involvement. Surg Neurol. 1976 Dec;6(6):341–343. [PubMed]

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