Bilateral chiasm and optic nerve micro-decompression in a child with extensive cranial fibrous dysplasia: how I do it

Abstract

Background: Surgical decompression to the optic-chiasmatic region in craneofacial fibrous dysplasia (CFD) must be performed safely to improve or stabilize visual loss.

Method: We describe a technical nuance when facing on a huge, deformed skull with potentially imbricated dura mater. Craniectomy was performed in concentric arches allowing to expose surgical field and elevated step by step. Bilateral micro-decompression was performed after without difficulties.

Conclusions: Decompressing both optic nerves using this technique is safe and relatively simple to perform.

Keywords: Concentric segments; Craneofacial fibrous dysplasia; Craniectomy; Fibrous dysplasia; Optic nerve decompression.