Key Clinical Findings & Highlights
- Combines advanced neurosurgical skull base decompression with custom 3D printed titanium implants.
- Restores exact symmetrical orbital volume and corrects ocular dystopia.
- Protects optic nerve integrity and prevents disease-related visual loss.
Abstract
Introduction & Background
Fibrous dysplasia is a non-neoplastic bone disorder wherein normal lamellar bone is replaced by immature woven bone and fibrous stroma. When extensive calvarial and orbital involvement occurs, simultaneous neurosurgical bone decompression and precise orbital volume restoration are essential.
Clinical Case Presentation & Diagnosis
A 28-year-old patient presented with marked unilateral exophthalmos, downward ocular dystopia, and facial asymmetry. High-resolution CT with 3D stereolithographic virtual modeling showed massive expanding ground-glass fibrous dysplasia replacing the orbital roof, frontal calvarium, and lateral orbital wall.
Surgical Technique & Management
A fronto-orbital craniotomy and anterior cranial fossa extradural approach were performed. The diseased, thickened skull base bone was radically thinned and excised with optic canal decompression. A custom prefabricated 3D titanium mesh prosthesis matching the contralateral mirror orbit was positioned and secured with titanium screws.
Discussion & Literature Context
The custom patient-specific implant restored anatomical intraorbital volume with sub-millimeter precision, avoiding postoperative enophthalmos or diplopia while providing permanent protective separation between the intracranial contents and orbital cone.
Conclusion
Transcranial decompression combined with custom 3D patient-specific implants provides state-of-the-art functional and aesthetic outcomes in complex craniofacial fibrous dysplasia.
How to Cite This Research
S. Rao, Dr. Surendra K. Gupta, S. Burman, L. Nehete, M. Ravina, S. Rao, N. K. Bodhey (2021). "Transcranial Orbital Reconstruction Using Patient-Specific Implant Prosthesis in Craniofacial Fibrous Dysplasia". Journal of Maxillofacial and Oral Surgery, Volume 21, Issue 4, Pages 1-6.
