title: Orbitocranial Fibrous Dysplasia: Outcome of Radical Resection and Immediate Reconstruction With Titanium Mesh and Pericranial Flap.
abstract: BACKGROUND
  Fibrous dysplasia (FD) is a non-neoplastic developmental fibro-osseous disease. It represents 2.5% of all bone tumors and 5% to 7% of the benign bone tumors. Orbitocranial region is involved in about 20% of the patients. The main presentations are craniofacial deformity and headache. Loss of vision is the most devastating result of this disease. There is no medical treatment to cure or prevent FD. Radiation therapy is contraindicated. Surgery for the orbitocranial FD is often challenging because of the proximity of neurovascular and ocular structures. Conservative surgical shaving and recontouring is always associated with suboptimal results. Radical excision is potentially curative with no extra morbidity. Orbital hypertelorism, dystopia, or proptosis can be corrected only by radical excision and reconstruction.
  
  
  OBJECTIVE
  The aim of the study was to evaluate the outcome of radical excision of the orbitocranial FD and immediate reconstruction using titanium mesh and pericranial flap.
  
  
  METHODS
  This prospective study had been conducted on 22 patients with orbitocranial FD with age range from 17 to 52 years (mean 29.5). Radical excision of the lesions was done for all patients through transcranial approach. Immediate reconstruction was achieved using titanium mesh and pericranial flap.
  
  
  RESULTS
  Intraoperative dural tears and cerebrospinal fluid leak were reported in 2 patients and repaired with galeal graft. Supraorbital anesthesia occurred in 6 patients. Of these, 2 patients were transient, while the remaining 4 patients were permanent. Wound infection was noticed in 1 patient who improved by medical treatment. Temporary postoperative diplopia occurred in 1 patient and temporary postoperative impaired vision in 1 other patient. In all patients, acceptable or good aesthetic results were observed. No recurrence was detected in our series during the follow-up period that ranged from 24 to 58 months (mean 37.5 months).
  
  
  CONCLUSIONS
  Radical excision of orbitocranial FD is potentially curative with no extra morbidity. It can achieve good aesthetic and functional results with no recurrence.
authors.affiliation: *Neurosurgery Department†Maxillofacial Surgery Unit, Faculty of Medicine, Sohag University, Sohag, Egypt.
authors.forename: Khalid Nasser
authors.initials: KN
authors.lastname: Fadle
authors.forename: Ahmed Gaber
authors.initials: AG
authors.lastname: Hassanein
authors.forename: Abdin K
authors.initials: AK
authors.lastname: Kasim
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005359:Fibrous Dysplasia, Polyostotic / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D011446:Prospective Studies; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000379:methods*; D012535:Scalp / Q000637:transplantation; D012886:Skull / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D013524:Surgical Flaps; D013526:Surgical Mesh; D014025:Titanium; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014025:Titanium