Recurrent Pediatric Orbitofacial Plexiform Neurofibroma With Cavernous Sinus Extension: Craniofacial Debulking and Eyelid-Sparing Exenteration.

Authors

Federico Sacasa, María Eugenia Lara, Melina Quezada, Alberto Hernández

Published in

The Journal of craniofacial surgery. Nov 04, 2026. Epub Nov 04, 2026.

Abstract

Advanced pediatric orbitofacial plexiform neurofibroma may require coordinated decisions regarding globe sacrifice, cranial-base protection, soft-tissue coverage, and future rehabilitation. We describe a 5-year-old girl with recurrent orbitofacial plexiform neurofibroma involving the entire orbit, optic nerve, extraocular muscles, multiple cranial nerves, cavernous sinus, and deep craniofacial soft tissues. Management included craniofacial debulking, eyelid-sparing orbital exenteration, intentional residual disease in high-risk compartments, immediate orbital roof/temporal cranial-base reconstruction, and primary closure using the preserved native eyelid-facial envelope. At 12-month follow-up, compressive orbital pain remained resolved, and facial contour was improved, with no clinical evidence of progression. Follow-up MRI demonstrated marked reduction in tumor volume compared with preoperative imaging and persistent residual disease involving the left cavernous sinus.

PMID:
42980473
Bibliographic data and abstract were imported from PubMed on 04 Nov 2026.

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