Fibrous dysplasia of the skull base

This study examined the presentation, surgical complications, and outcome associated with treating 82 cases of skull base fibrous dysplasia (SBFD). Eighty-two cases of SBFD were identified. All pathology was reviewed by a senior pathologist (K. Unni). The medical records were reviewed for presenting symptoms, treatment, surgical complications, outcome, and follow-up. Fifty-one males (62)% and 31 females (38%), mean age 24 years, were operated on. Distributed in frontal 72%, ethmoid 61%, sphenoid 57%, fronto-ethmoid-sphenoidal 39%, frontoethmoidal 38%, temporal 12%, and occipital 12% locations. Orbit involved in 66%. Patients presented with facial asymmetry 61%, proptosis 41%, headache 39%, and visual loss 15%. Gross total resection was achieved in 51%, and subtotal 49%. Complications included anosmia 13%, visual worsening 11%, infection 10%, ocular paresis 4%, CSF leak 2.5%. One patient spontaneously progressed to fibrosarcoma. Mean follow-up was 11 years (range 0-55) Twenty-two percent had progression of residual FD (4% symptomatic).