title: Simultaneous decompression of the orbital lateral wall and optic canal for fibrous dysplasia in early adolescence.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
authors.affiliation: Department of Neurosurgery, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Tamura
authors.affiliation: Department of Neurosurgery, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan.
authors.forename: Tomoru
authors.initials: T
authors.lastname: Miwa
authors.affiliation: Department of Plastic and Reconstructive Surgery, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Sakamoto
authors.affiliation: Department of Neurosurgery, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan.
authors.forename: Maya
authors.initials: M
authors.lastname: Kohno
authors.affiliation: Department of Plastic and Reconstructive Surgery, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kishi
authors.affiliation: Department of Neurosurgery, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Yoshida
keywords: Early adolescence; Fibrous dysplasia; Optic canal; Orbital lateral wall