S16-11 SESSION 16: PLANNING/IMAGING – PART II SUBCRANIOTOMY STRATEGY WITH NAVIGATION FOR OPTIC NERVE DECOMPRESSION IN FRONTOORBITAL FIBROUS DYSPLASIA

Abstract

Introduction: For correction of frontoorbital fibrous dysplasia involving optic nerve, controversy has surrounded the role of optic nerve decompression in a number of ways. We describe a way with subcraniotomy strategy according to navigation for intraorbital unit optic nerve decompression. Methods: 21 cases of patients with frontoorbital fibrous dysplasia were investigated in a retrospective manner. They underwent unilateral intraorbital optic nerve decompression with the help of 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, all 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. Conclusion: Surgical management should be tailored to each patient, which is based on the most possible potential etiology. Intraorbital optic nerve decompression may be more feasible and safer with the help of this strategy and navigation, especially for those with exophthalmos, orbital volume decreasing, and nonacute visual loss.