Surgery vs. Watchful Waiting for Craniofacial Fibrous Dysplasia
Author Information
Author(s): Amit Moran, Collins Michael T., Edmond J. FitzGibbon, John A. Butman, Dan M. Fliss, Ziv Gil
Primary Institution: Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University
Hypothesis
What is the long-term outcome of patients with optic nerve compression due to craniofacial fibrous dysplasia who either undergo surgery or are managed expectantly?
Conclusion
Most patients with craniofacial fibrous dysplasia will remain asymptomatic during long-term follow-up, and expectant management is recommended for asymptomatic patients.
Supporting Evidence
- 58% of clinically impaired optic nerves showed improvement after surgery.
- 75.6% of operated intact nerves maintained stable vision compared to 95.1% of non-operated ones.
- Surgery in asymptomatic patients was linked to visual deterioration.
Takeaway
This study found that many people with a certain bone condition don't need surgery and can just be watched over time, as they often don't have problems.
Methodology
A meta-analysis of 27 studies and a cohort analysis of patients enrolled in a NIH protocol.
Potential Biases
Higher proportion of patients with McCune Albright syndrome in the expectantly managed group may skew results.
Limitations
The study had referral bias and was retrospective, limiting control over confounding variables.
Participant Demographics
Median age was 20 years, with a mix of symptomatic and asymptomatic patients.
Statistical Information
P-Value
0.0003
Confidence Interval
95% CI 2.26–10.59
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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