Radical treatment for fronto-orbital fibrous dysplasia: the chain-link fence

Fronto-orbital fibrous dysplasia is a progressive disease whose growth does not cease at puberty. It causes frontal protuberance, orbital dystopia, and proptosis. Occasionally, there is a neural entrapment. Malignant change may occur spontaneously or as a result of irradiation. Radical resection offers the greatest chance of cure and correction of the entire deformity. Five patients treated by the Toronto Craniofacial Team are reported. This team has developed techniques for one-stage removal and immediate reconstruction with rib grafts. Rigid fixation of the grafts utilizing the chain-link fence principle has proved that if bone grafts are considered as skin grafts and rapid revascularization is permitted, no resorption or loss of contour occurs.