title: [Endoscopic transnasal surgery for giant fibrous dysplasia of the skull base, spreading to the right orbital cavity and nasopharynx (a case report and literature review)].
abstract: BACKGROUND
  An extended endoscopic endonasal approach is increasingly used in surgical treatment of space-occupying skull base lesions. The international literature reports only 20 cases of surgical treatment for fibrous dysplasia (PD) of the skull base using the endoscopic endonasal approach. We present our experience with the endoscopic endonasal approach in surgical treatment for giant fibrous dysplasia of the skull base, spreading to the right orbital cavity and nasopharynx.
  
  
  METHODS
  A 26-year-old male patient presented with cranial pain, Vth nerve dysfunction on the right, right keratopathy. OD=0.2 (near acuity - 0.3), OS=1.0, OD - incomplete eyelid closure of 2 mm, conjunctival injection, mucous discharge, corneal opacity in the lower pole and paracentrally, OS - normal appearance. Severe right-sided exophthalmos (more than 15 mm), impaired nasal breathing on the right, nasal (hemorrhagic) discharge. Magnetic resonance imaging and spiral computed tomography scans revealed a bone density lesion located in the area of the orbit, nasal cavity, maxillary sinus on the right, and labyrinth of the ethmoid bone. The patient underwent endonasal endoscopic resection of the lesion.
  
  
  RESULTS
  The lesion was resected totally, which was confirmed by control SCT. Right-sided exophthalmos partially regressed (on the right: exophthalmos of 8 mm; protrusion: OD=23 mm, OS=15 mm; the eyeball was displaced downward and outward). The visual and oculomotor functions did not change. The neurological status remained at the preoperative level.
  
  
  CONCLUSIONS
  Fibrous dysplasia of the skull base is an extremely rare disease. Modern techniques expand the indications for surgery of giant tumors of the skull base using minimally invasive approaches, in particular the endoscopic endonasal approach.
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: A N
authors.initials: AN
authors.lastname: Shkarubo
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: A Yu
authors.initials: AY
authors.lastname: Lubnin
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: E Yu
authors.initials: EY
authors.lastname: Bukharin
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: L V
authors.initials: LV
authors.lastname: Shishkina
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: D N
authors.initials: DN
authors.lastname: Andreev
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: K V
authors.initials: KV
authors.lastname: Koval'
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: I V
authors.initials: IV
authors.lastname: Chernov
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: V V
authors.initials: VV
authors.lastname: Karnaukhov
mesh_terms: D000328:Adult; D005357:Fibrous Dysplasia of Bone / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D009302:Nasopharyngeal Diseases / Q000473:pathology / Q000601:surgery; D009305:Nasopharynx / Q000473:pathology / Q000601:surgery; D009915:Orbit / Q000473:pathology / Q000601:surgery; D019291:Skull Base / Q000473:pathology / Q000601:surgery