Visual loss associated with fibrous dysplasia of the anterior skull base -Case report and review of the literature

The authors present a case of visual loss associated with fibrous dysplasia of the anterior skull base and the surgical management of this case. Preop erative computerized tomography scanning in this patient demonstrated a pat ent optic foramen and a rapidly growing cystic mass within the orbit, which was responsible for the patient's visual loss. A literature review reveale d that this case is typical, in that cystic mass lesions of various types a re frequently responsible for visual loss associated with fibrous dysplasia . The authors did not find significant evidence in the literature to suppor t the notion that visual loss associated with fibrous dysplasia is the resu lt of progressive optic canal stenosis, thus raising questions about the va lue of prophylactic optic canal decompression. Instead, as demonstrated by this case and those uncovered in the literature review, most instances of v isual loss result from the rapid growth of mass lesions of cystic fibrous d ysplasia, mucoceles, or hemorrhage. Findings of the literature review and t he present case of fibrous dysplasia of the anterior skull base support a r ole for extensive surgical resection in these cases and indicate a need for additional prospective analysis of a larger number of patients with this d isease.