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  • Sight preserving orbital decompression: a novel multidisciplinary approach to managing severe proptosis in neurofibromatosis type 2

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Novel treatment (new drug/intervention; established drug/procedure in new situation)
CASE REPORT
Sight preserving orbital decompression: a novel multidisciplinary approach to managing severe proptosis in neurofibromatosis type 2
  1. George Henry Lafford1,
  2. Simon James Eccles2,
  3. Jahrad Haq2,
  4. Nara Orban3
  1. 1 Craniofacial Unit, Imperial College Faculty of Medicine—Chelsea and Westminster Campus, London, UK
  2. 2 Craniofacial Unit, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  3. 3 ENT Department, Charing Cross Hospital, London, UK
  1. Correspondence to Dr George Henry Lafford, georgelafford{at}gmail.com

Summary

We describe the importance of collaboration between multiple surgical specialties in managing a complex case of sight-threatening severe proptosis in a young woman with type 2 neurofibromatosis (NF2) complicated by pre-existing contralateral blindness. Trans-nasal and lateral orbital surgical approaches were aided by stereotactic navigation to debulk a large frontal/sphenoid wing meningioma, which had been exerting pressure onto the right globe and optic nerve. The patient made an excellent postoperative recovery along with preserved residual visual acuity, normal neurology and a good aesthetic outcome.

  • neurosurgery
  • plastic and reconstructive surgery
  • otolaryngology/ent
  • neuroopthalmology

https://doi.org/10.1136/bcr-2017-221462

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    Footnotes

    • Contributors GHL gathered the information, patient consent and drafted all sections of the report. SJE helped write the treatment section especially regarding craniofacial surgical input and follow-up. JH edited and helped to write the introduction, summary and background sections. NO edited and helped write the ENT surgical management and discussion sections.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.