title: "Well Digging" Subcraniotomy Strategy with Navigation for Optic Nerve Decompression in Frontoorbital Fibrous Dysplasia: Preliminary Experience.
abstract: BACKGROUND
  During the past decades, surgical intervention has been the primary treatment modality for frontoorbital fibrous dysplasia involving optic nerve. However, controversy has surrounded the role of optic nerve decompression in a number of ways. Herein, we describe 3 patients with frontoorbital fibrous dysplasia involving optic nerve, who underwent a "well digging" subcraniotomy strategy with navigation for intraorbital unit optic nerve decompression.
  
  
  METHODS
  From 2013 to 2015, 3 patients with frontoorbital fibrous dysplasia were investigated in a retrospective manner. They underwent unilateral intraorbital optic nerve decompression with the help of "well digging" strategy and navigation. The key procedures comprise preoperative software simulation, frontoorbital subcraniotomy (like digging a well), expanding cone-shaped surgical field, intraorbital unit optic nerve decompression with navigation, correcting frontal-orbital dystopias, and deformities.
  
  
  RESULTS
  Both at the immediate postoperative period and during the 3-12 months follow-up, 2 cases showed improvement of visual acuity in the affected eye and 1 case showed no deterioration. Other ocular examinations including eye movement were stable. Subsequent reconstruction yielded a satisfactory cosmetic result. No postoperative complications happened.
  
  
  CONCLUSIONS
  In our philosophy, surgical management should be tailored to each patient, which is based on the most possible potential etiology. We consider that the intraorbital optic nerve decompression may be more feasible and safer with the help of "well digging" strategy and navigation, especially for those with exophthalmos, orbital volume decreasing, and nonacute visual loss.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Yunhe
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Division of Plastic and Reconstructive Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Junyi
authors.initials: J
authors.lastname: Yang
authors.affiliation: Division of Plastic and Reconstructive Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Yingzhi
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Division of Plastic and Reconstructive Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Sida
authors.initials: S
authors.lastname: Pan
authors.affiliation: Division of Plastic and Reconstructive Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Jiawen
authors.initials: J
authors.lastname: Lu
authors.affiliation: Division of Plastic and Reconstructive Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Xiongzheng
authors.initials: X
authors.lastname: Mu