Huge fibrous dysplasia of the paranasal sinuses - Case report

Fibrous dysplasia is a benign disorder in which normal bone is replaced by abnormal fibrous tissue. When the paranasal sinus is involved, it will lead to nasal obstruction, facial deformity, occular proptosis, visual impairment, and even cranial bone invasion. Surgery is the mainstay of treatment. We experienced a case of huge fibrous dysplasia of left paranasal sinuses in 1996. An 11 year-old boy had suffered from left nasal obstruction since 2 years ago, and had progressive diplopia and visual impariment in recent months. A gray whitish tumor with smooth surface was found in left nasal cavity. Computered tomography of the sinuses revealed that left maxillary sinus, ethmoid sinus, and sphenoid sinus were occupied by a huge homogenous tumor. Optic nerve was also compressed. Operations by left lateral rhinotomy and medial maxillectomy were performed to enter paranasal sinuses with removal of tumor and decompression of optic nerve. Then the orbital and facial bone were reconstructed with a rib and a free forearm flap. The postoperative course was unevenful, with resolution of diplopia and improvement of visual acuity.