Decortication of fibrous dysplasia of the maxillary sinus

We present 3 cases of fibrous dysplasia of the maxillary sinus that were treated by decortication through the anterior wall of the maxilla. The thickened anterior wall of the maxilla and the zygoma were contoured into normal shape with a bur, and a 2 × 2-cm window was made below the infraorbital foramen using a reciprocating saw. The removed piece of bone was 3 to 5 mm thick. All abnormal fibrous tissues in the maxillary sinus were extirpated by drilling through the window until the sinus cavity was clear. The preserved bone plate was restored in place to close the window of the maxillary anterior wall and fixed with miniplates. Three patients were treated by means of such internal decompression method. No overgrowth or disfigurement of the facial bone was appreciated 14 to 51 months postoperatively. We contend that internal decortication of fibrous dysplasia through a window in the anterior wall is effective to minimize external expansion of fibrous dysplasia.