The surgical management of childhood orbito-temporal neurofibromatosis

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Presentation transcript:

The surgical management of childhood orbito-temporal neurofibromatosis Vickie Lee, Nicola K Ragge, J.Richard O Collin British Journal of Plastic Surgery Volume 56, Issue 4, Pages 380-387 (June 2003) DOI: 10.1016/S0007-1226(03)00172-3

Fig. 1 Case 1 (age 4): Complete left blepharoptosis with brow and facial asymmetry. British Journal of Plastic Surgery 2003 56, 380-387DOI: (10.1016/S0007-1226(03)00172-3)

Fig. 2 Case 1 (age 4): extensive conjunctival neurofibroma infiltration involving the lacrimal gland. British Journal of Plastic Surgery 2003 56, 380-387DOI: (10.1016/S0007-1226(03)00172-3)

Fig. 3 Case 1 (age 12) with recurrence of NF infiltration but with her upper lid still remained clear of the pupillary axis. British Journal of Plastic Surgery 2003 56, 380-387DOI: (10.1016/S0007-1226(03)00172-3)

Fig. 4 Case 3 (age 7) right congenital blepharoptosis and pulsating exophthalmos. British Journal of Plastic Surgery 2003 56, 380-387DOI: (10.1016/S0007-1226(03)00172-3)

Fig. 5 Case 3 (age 12) after enucleation and ptosis surgery (wearing an ocular prosthesis). British Journal of Plastic Surgery 2003 56, 380-387DOI: (10.1016/S0007-1226(03)00172-3)

Fig. 6 Case 3 (age 17) for debulking of his greatly thickened right brow area was carried. British Journal of Plastic Surgery 2003 56, 380-387DOI: (10.1016/S0007-1226(03)00172-3)

Fig. 7 Case 3 (age 24) after lower lid fascial sling, brow lift and further debulking surgery. British Journal of Plastic Surgery 2003 56, 380-387DOI: (10.1016/S0007-1226(03)00172-3)

Fig. 8 Case 4 (age 13) complete right blepharoptosis. British Journal of Plastic Surgery 2003 56, 380-387DOI: (10.1016/S0007-1226(03)00172-3)

Fig. 9 Case 4 (age 13) marked postoperative conjunctival prolapse following anterior levator resection. British Journal of Plastic Surgery 2003 56, 380-387DOI: (10.1016/S0007-1226(03)00172-3)

Fig. 10 Case 4 (age 13) resolution of conjunctival prolapse after a full thickness lateral lid resection 5 days later. British Journal of Plastic Surgery 2003 56, 380-387DOI: (10.1016/S0007-1226(03)00172-3)

Fig. 11 Case 4 (age 17) after extraocular muscle transposition and a Crawford type frontalis suspension with autogenous fascia lata and a right frontal craniotomy. British Journal of Plastic Surgery 2003 56, 380-387DOI: (10.1016/S0007-1226(03)00172-3)

Fig. 12 Case 6 (age 12) severe right upper and lower lid neurofibromatosis, pulsating exophthalmos and a blind eye. British Journal of Plastic Surgery 2003 56, 380-387DOI: (10.1016/S0007-1226(03)00172-3)

Fig. 13 Case 6 (age 12) after full thickness upper and lower lid resection and enucleation. British Journal of Plastic Surgery 2003 56, 380-387DOI: (10.1016/S0007-1226(03)00172-3)

Fig. 14 (age 21) After canthal reattachment with a lower lid autogenous fascia lata sling. British Journal of Plastic Surgery 2003 56, 380-387DOI: (10.1016/S0007-1226(03)00172-3)

Fig. 15 (age 29) After further ptosis and debulking surgery. British Journal of Plastic Surgery 2003 56, 380-387DOI: (10.1016/S0007-1226(03)00172-3)

Fig. 16 Case 7 (age 15) bulk of neurofibromas in this patient's socket resulting in the poor fitting of a large cosmetic shell designed to lift the right upper lid. British Journal of Plastic Surgery 2003 56, 380-387DOI: (10.1016/S0007-1226(03)00172-3)

Fig. 17 Case 7 (age 17) reasonable cosmesis after orbital debulking and ptosis surgery with new ocular prosthesis. British Journal of Plastic Surgery 2003 56, 380-387DOI: (10.1016/S0007-1226(03)00172-3)

Fig. 18 Case 9 (age 12) subtle orbito-temporal NF with mild ptosis and ocular dystopia after levator surgery 6 years earlier. British Journal of Plastic Surgery 2003 56, 380-387DOI: (10.1016/S0007-1226(03)00172-3)