Surgery of massive fibrous dysplasia and osteoma of the midface.

Since most bony lesions of the midface will stop growing or regress, it is generally not appreciated when fibrous dysplasia and osteoma occasionally continue to grow, causing functional and cosmetic problems. To demonstrate the potential of the disease processes and management options available to the surgeon, a series of patients with massive fibrous dysplasia and osteoma of the midface is reviewed. Most of the patients show a facial deformity alone or in combination with telecanthus, epiphora, exophthalmos, or nasal obstruction. Several types of radical and conservative surgical procedures are described to remove or control the bony lesions, to restore facial contour, and to reconstruct the sinuses, nasal passageways, lacrimal collecting system, and medial wall of the orbit.