Surgical treatment of skull fibrous dysplasia

Peng, Lei; Bai, Hongtao; Wang, Yu; Liu, Qi

doi:10.1016/j.surneu.2008.03.041

Cited by 16 publications

(14 citation statements)

References 15 publications

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“…Lei et al . [ 14 ] published a series of 12 operated patients with cranial FD where they showed that in indicated patients, complete excision with reconstruction is feasible in one stage like we have shown in our study. Like in our study, they also used autologous bone as well as artificial mesh.…”

Section: Discussionsupporting

confidence: 69%

Cranial fibrous dysplasia: An institutional experience and review of the literature

Diyora

Dey

Dubey

et al. 2022

Surgical Neurology International

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Background: Cranial or craniofacial fibrous dysplasia (CFD) is a rare entity which most often presents with either incidental finding or with pain/cosmetic disfigurement or visual/hearing problems. Multidisciplinary treatment with close follow-up or medical management/surgery is options. Management of these lesions can often give satisfying results. There is a dearth of neurosurgical literature on this subject matter. Our objective was to review the clinical symptomatology and outcome of CFD patients managed in our institution. Methods: This is a retrospective observational study of CFD patients managed in our institution over a period of 5 years. Clinical and radiological data were collected from departmental database. Outcomes were evaluated immediately and on 1–4 years follow-up. Results: A total of 21 patients were managed over a period of 5 years with age ranging from 12 to 55 years and symptoms of cosmetic issues or visual disturbance. Preoperative computed tomography scan with 3D reconstruction with bone window was done in all patients. In most of the patients (16/20), immediate reconstruction was done following excision. Five patients were managed conservatively. Follow-up was obtained over a period ranging from 1 to 4 years and all (except one) patients are doing well. Only one patient had permanent visual impairment in spite of early intervention. Conclusion: Craniofacial dysplasia has various modalities of management. Careful selection of patients for surgical or conservative management is feasible with good results both in short and long term.

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Section: Discussionsupporting

confidence: 69%

Cranial fibrous dysplasia: An institutional experience and review of the literature

Diyora

Dey

Dubey

et al. 2022

Surgical Neurology International

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“…Lei et al attributed a high risk of optic nerve injury to the sensitivity of the already damaged nerve to surgical insult [40]. Three patients in our cohort who underwent simultaneous or sequential prophylactic decompression in the contralateral eye resulted in bilateral blindness.…”

Section: Discussionmentioning

confidence: 68%

Surgery versus Watchful Waiting in Patients with Craniofacial Fibrous Dysplasia – a Meta-Analysis

et al. 2011

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BackgroundFibrous dysplasia (FD) is a benign bone tumor which most commonly involves the craniofacial skeleton. The most devastating consequence of craniofacial FD (CFD) is loss of vision due to optic nerve compression (ONC). Radiological evidence of ONC is common, however the management of this condition is not well established. Our objective was to compare the long-term outcome of patients with optic nerve compression (ONC) due to craniofacial fibrous dysplasia (CFD) who either underwent surgery or were managed expectantly.Methodology/Principal FindingsWe performed a meta-analysis of 27 studies along with analysis of the records of a cohort of patients enrolled in National Institutes of Health (NIH) protocol 98-D-0145, entitled Screening and Natural History of Fibrous Dysplasia, with a diagnosis of CFD. The study group consisted of 241 patients; 122 were enrolled in the NIH study and 119 were extracted from cases published in the literature. The median follow-up period was 54 months (range, 6–228 months). A total of 368 optic nerves were investigated. All clinically impaired optic nerves (n = 86, 23.3%) underwent therapeutic decompression. Of the 282 clinically intact nerves, 41 (15%) were surgically decompressed and 241 (85%) were followed expectantly. Improvement in visual function was reported in fifty-eight (67.4%) of the clinically impaired nerves after surgery. In the intact nerves group, long-term stable vision was achieved in 31/45 (75.6%) of the operated nerves, compared to 229/241 (95.1%) of the non-operated ones (p = 0.0003). Surgery in asymptomatic patients was associated with visual deterioration (RR 4.89; 95% CI 2.26–10.59).ConclusionsMost patients with CFD will remain asymptomatic during long-term follow-up. Expectant management is recommended in asymptomatic patients even in the presence of radiological evidence of ONC.

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“…Optic nerve decompression in the asymptomatic patients is not risk free, as cases of blindness and visual deterioration have been reported [9]. Lei et al attributed a high risk of optic nerve injury to the sensitivity of the already damaged nerve to surgical insult [40]. Three patients in our cohort who underwent simultaneous or sequential prophylactic decompression in the contralateral eye resulted in bilateral blindness.…”

Section: Discussionmentioning

confidence: 60%

Surgery versus Watchful Waiting in Patients with Craniofacial Fibrous Dysplasia: A Meta-Analysis

Amit¹,

Collins²,

FitzGibbon³

et al. 2012

J Neurol Surg B

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Background: Fibrous dysplasia (FD) is a benign bone tumor which most commonly involves the craniofacial skeleton. The most devastating consequence of craniofacial FD (CFD) is loss of vision due to optic nerve compression (ONC). Radiological evidence of ONC is common, however the management of this condition is not well established. Our objective was to compare the long-term outcome of patients with optic nerve compression (ONC) due to craniofacial fibrous dysplasia (CFD) who either underwent surgery or were managed expectantly.

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Surgical treatment of skull fibrous dysplasia

Cited by 16 publications

References 15 publications

Cranial fibrous dysplasia: An institutional experience and review of the literature

Cranial fibrous dysplasia: An institutional experience and review of the literature

Surgery versus Watchful Waiting in Patients with Craniofacial Fibrous Dysplasia – a Meta-Analysis

Surgery versus Watchful Waiting in Patients with Craniofacial Fibrous Dysplasia: A Meta-Analysis

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