Unilateral extradural approach for bilateral optic canal release in a patient with fibrous dysplasia

A 4-year-old girl suffering from left visual loss and orbitofrontal deformity secondary to fibrous dysplasia was treated surgically. Using an extradural approach through a left frontotemporal craniotomy, the dysplastic orbital roof, sphenoid wing, anterior clinoid process, planum sphenoidale, and sphenoid body were removed to release the left superior orbital fissure and the optic canals bilaterally. The superior marginal bone of the left orbit was elevated to make it even with the contralateral side. After autoclaving at 132 degrees C and 2 atm for 10 minutes to prevent continued growth, a section of dysplastic frontotemporal bone was remodeled and replaced. Surgical methods are discussed, focusing on the merits of an extradural approach.