title: Surgical correction in orbitotemporal neurofibromatosis with dystopia.
abstract: BACKGROUND
  Orbitotemporal neurofibromatosis is a challenging disease for orbital surgeons. Ptosis correction may be needed following correction of orbital dystopia.
  
  
  METHODS
  A 34-year-old man, who underwent excision of a neurofibroma on the right eyelid in our clinic, returned to our clinic four years later complaining of dystopia and bulkiness of the protruding mass in the right eyelid and eyebrow. Computed tomographic imaging showed dysplasia and deformity in the sphenoid bone and orbit. A large mass was found in the superior portion of the orbit, protruding towards the temporal lobe, which in turn displaced the orbit downwards. A bicoronary incision and transcranial approach were performed, followed by the excision of the superior orbital space and temporal lobe mass by uncovering certain portions of the frontal, temporal, and zygomatic bones. After the excision of the mass, a calvarial bone graft was used to remodel the longitudinal widened orbit to correct the dystopia. While primary surgery was successful in the correction of dystopia, secondary surgery was performed to correct the exacerbated ptosis by levator muscle resection.
  
  
  CONCLUSIONS
  Correction of orbitotemporal neurofibromatosis with dystopia involves three steps: removal of the mass in the orbit to eliminate the effect of downward dislocation of the orbit, placement of a bone graft in the orbit floor after repositioning the orbit for suspension and remodeling of the orbit, and following the correction of dystopia, ptosis may be corrected if needed.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, 11923, South Korea.
authors.forename: Matthew Seung Suk
authors.initials: MSS
authors.lastname: Choi
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, 11923, South Korea.
authors.forename: Seung Hyup
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, 11923, South Korea. pslee@hanyang.ac.kr.
authors.forename: Jang Hyun
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000328:Adult; D001763:Blepharoptosis / Q000601:surgery*; D019465:Craniofacial Abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D009455:Neurofibroma / Q000000981:diagnostic imaging / Q000601:surgery*; D009801:Oculomotor Muscles / Q000601:surgery; D013508:Ophthalmologic Surgical Procedures; D009918:Orbital Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D013100:Sphenoid Bone / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed