Zygoma Reduction Surgery for Fibrous dysplasia with protection of infraorbital nerve surgery

Presentation of fibrous dysplasia

Fibrous dysplasia is a very rare disorder of the bone. The gene involved is the G-protein receptor. It is a condition where fibrous tissue replaces normal bone and marrow tissue. This results in bone that is very weak. There is also excessive proliferation of this fibrous bony tissue. This leads to increased size of the affected bone. Surgical correction is the only solution for fibrous dysplasia.

A patient with fibrous dysplasia presents at Balaji Dental and Craniofacial Hospital

This patient presented to Balaji Dental and Craniofacial Hospital for treatment. He had increased asymmetric growth of the right zygomatic bone. Dr S M Balaji, Craniomaxillofacial surgeon, examined the patient and ordered investigations. Biopsy revealed it to be fibrous dysplasia. He explained the condition to the patient and his treatment plan. The patient was in complete agreement with the treatment plan.

Surgical correction of fibrous dysplasia

Under general anesthesia, an incision was first made. This extended from the outer canthus of the right eye. Dissection was then carried down to the frontal part of the zygomatic bone. Next, a vestibular incision was then made in the right maxillary sulcus. Dissection was next carried down to the dysplastic zygomatic bone. Fibrous tissue of the zygomatic bone was next trimmed with burs and chisels. Access was through both incisions. Adequate trimming of fibrous tissue was then completed and facial symmetry restored. The incisions were then closed with sutures. Great care was always taken to preserve the infraorbital nerve. Testing of the nerve at the end of surgery revealed no neuropraxia or other signs of nerve injury.

The patient expressed his happiness at the results of the surgery before discharge.

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