Single-stage complex reconstruction for fibrous dysplasia: a case report

Area of Science:

• Neurosurgery
• Craniofacial Surgery
• Biomedical Engineering

Background:

• Fibrous dysplasia is a benign skeletal condition affecting the craniofacial region, often necessitating surgical intervention for deformity correction and neurovascular decompression.
• Traditional surgical methods involve bone grafting, leading to prolonged, multisite procedures and potential complications.
• Custom implants offer an alternative but typically require staged procedures, leaving interim bony defects.

Observation:

• A 32-year-old woman with McCune-Albright syndrome presented with right facial pain, deformity, and proptosis due to extensive fibrous dysplasia.
• Imaging revealed orbital mass effect and nerve compression, indicating the need for surgical intervention.

Findings:

• A novel single-stage approach was employed, utilizing preoperative cranial modeling from high-resolution CT scans for custom implant design.
• The procedure involved single-stage resection of affected craniofacial bones and immediate reconstruction with the custom implant.
• The patient experienced significant relief from pain and pressure, with resolution of proptosis and improved sensation post-surgery.

Implications:

• Preoperative cranial modeling and custom implant design enable a streamlined, one-step surgical solution for craniofacial fibrous dysplasia.
• This technique minimizes operative time and morbidity compared to traditional methods.
• The approach achieves satisfactory structural and cosmetic results, enhancing patient quality of life.