Endoscopic transsphenoidal optic nerve decompression: an anatomical study

2010 ◽  
Vol 33 (3) ◽  
pp. 257-262 ◽  
Author(s):  
Marco Locatelli ◽  
Manuela Caroli ◽  
Mauro Pluderi ◽  
Federica Motta ◽  
Sergio Maria Gaini ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Anatomical Study ◽  
Nerve Decompression ◽  
Optic Nerve Decompression

scholarly journals Anatomical study of the possibilities of endoscopic transnasal and endoscopic transorbital medial orbitotomy and decompression of the optic nerve

2019 ◽  
Vol 21 (3) ◽  
pp. 52-57 ◽  
Author(s):  
A. A. Kalandari ◽  
O. V. Levchenko ◽  
D. E. Zakondyrin ◽  
N. Yu. Kutrovskaya
Keyword(s):  
Optic Nerve ◽  
Angle Of Attack ◽  
Anatomical Study ◽  
Large Area ◽  
Study Objective ◽  
Nerve Decompression ◽  
Area Of Interest ◽  
Optic Nerve Decompression ◽  
Endoscopic Transorbital ◽  
Endocrine Ophthalmopathy

The study objective is to examine the anatomical characteristics of transnasal endoscopic and transorbital endoscopic approaches to perform medial orbitotomy and decompression of the optic nerve.Materials and methods. The study was based on the results of anatomical approaches on cadavers. The comparison was carried out according to the following anatomical-surgical parameters: 1) the area of interest in mm2 ; 2) the area of orbitotomy in mm2 ; 3) the area of the optic nerve decompression in mm2 ; 4) the length of periorbital incision in mm; 5) the depth of the wound in mm; 6) the horizontal angle of attack in degrees; 7) the vertical angle of attack in degrees. The measurements were carried out using the Russian optical navigation system “Neuroplan”.Results. It has been established that the area of orbitotomy is noticeably larger, and the depth of the operative wound is smaller with the transorbital approach. It was also revealed that there are no noticeable differences in the area of the optic nerve decompression between the transnasal endoscopic and transorbital endoscopic approaches. In addition, there is a tendency for large angles of attack in both horizontal and vertical planes with transorbital access, which is probably due to the smaller depth of the wound and the possibility of lateral traction of the eyeball. It was determined that as with transnasal, as with transorbital approaches, the length of the periorbital incision did not differ significantly.Conclusion. The study demonstrates the equivalent possibilities of both transnasal and transorbital endoscopic approaches in the implementation of the medial orbitotomy and decompression of the optic nerve in patients with endocrine ophthalmopathy. Some advantages, in particular, a large area of orbitotomy, as well as the preservation of the paranasal structures, make it possible to speak out in favor of choosing transorbital endoscopic approaches to the medial wall of the orbit and the optic nerve when performing surgical decompression in this group of patients. Further collection of clinical material is needed for final results.

Endoscopic endonasal medial-to-lateral and transorbital lateral-to-medial optic nerve decompression: an anatomical study with surgical implications

2017 ◽  
Vol 127 (1) ◽  
pp. 199-208 ◽  
Author(s):  
Alberto Di Somma ◽  
Luigi Maria Cavallo ◽  
Matteo de Notaris ◽  
Domenico Solari ◽  
Thomaz E. Topczewski ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Morphometric Analysis ◽  
Case Series ◽  
Good Control ◽  
Anatomical Study ◽  
Optic Canal ◽  
Endoscopic Endonasal ◽  
Nerve Decompression ◽  
Bone Removal ◽  
Optic Nerve Decompression

OBJECTIVEDifferent surgical routes have been used over the years to achieve adequate decompression of the optic nerve in its canal including, more recently, endoscopic approaches performed either through the endonasal corridor or the transorbital one. The present study aimed to detail and quantify the amount of bone removal around the optic canal, achievable via medial-to-lateral endonasal and lateral-to-medial transorbital endoscopic trajectories.METHODSFive human cadaveric heads (10 sides) were dissected at the Laboratory of Surgical Neuroanatomy of the University of Barcelona (Spain). The laboratory rehearsals were run as follows: 1) preliminary preoperative CT scans of each specimen, 2) anatomical endoscopic endonasal and transorbital dissections and Dextroscope-based morphometric analysis, and 3) quantitative analysis of optic canal bone removal for both endonasal and transorbital endoscopic approaches.RESULTSThe endoscopic endonasal route permitted exposure and removal of the most inferomedial portion of the optic canal (an average of 168°), whereas the transorbital pathway allowed good control of its superolateral part (an average of 192°). Considering the total circumference of the optic canal (360°), the transorbital route enabled removal of a mean of 53.3% of bone, mainly the superolateral portion. The endonasal approach provided bone removal of a mean of 46.7% of the inferomedial aspect. This result was found to be statistically significant (p < 0.05). The morphometric analysis performed with the aid of the Dextroscope (a virtual reality environment) showed that the simulation of the transorbital trajectory may provide a shorter surgical corridor with a wider angle of approach (39.6 mm; 46.8°) compared with the simulation of the endonasal pathway (52.9 mm; 23.8°).CONCLUSIONSUsed together, these 2 endoscopic surgical paths (endonasal and transorbital) may allow a 360° decompression of the optic nerve. To the best of the authors' knowledge, this is the first anatomical study on transorbital optic nerve decompression to show its feasibility. Further studies and, eventually, surgical case series are mandatory to confirm the effectiveness of these approaches, thereby refining the proper indications for each of them.

Emergency Endonasal Orbital and Optic Nerve Decompression—the ENT Surgeon's Perspective

2012 ◽  
Vol 73 (S 02) ◽  
Author(s):  
S. Mohanty ◽  
J. Samuel ◽  
G. Maraignanam
Keyword(s):  
Optic Nerve ◽  
Nerve Decompression ◽  
Optic Nerve Decompression

The Endoscopic Endonasal Transethmoido-Sphenoidal Optic Nerve Decompression: Surgical Technique, Case Series, and Potential Indications

2014 ◽  
Vol 75 (S 02) ◽  
Author(s):  
Berhouma Moncef ◽  
T. Jacquesson ◽  
T. Picart ◽  
L. Abouaf ◽  
J. Vighetto ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Surgical Technique ◽  
Case Series ◽  
Endoscopic Endonasal ◽  
Nerve Decompression ◽  
Optic Nerve Decompression

Optic Nerve Decompression with Release of the Meningo-Orbital Band in Medial Sphenoid Wing Meningiomas Improves and Preserves Visual Acuity

2016 ◽  
Vol 77 (S 02) ◽  
Author(s):  
Jebet Cheserem ◽  
Neda Barzegar-Befroei ◽  
Sinan Barazi ◽  
Nicholas Thomas
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Nerve Decompression ◽  
Optic Nerve Decompression

Supraorbital Keyhole Surgery for Optic Nerve Decompression and Dura Repair

2004 ◽  
Vol 21 (7) ◽  
pp. 976-981 ◽  
Author(s):  
Yuan-Hao Chen ◽  
Shinn-Zong Lin ◽  
Yung-Hsiao Chiang ◽  
Da-Tong Ju ◽  
Ming-Ying Liu ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Nerve Decompression ◽  
Keyhole Surgery ◽  
Optic Nerve Decompression

Endoscopic optic nerve decompression for traumatic optic neuropathy

1996 ◽  
Vol 7 (3) ◽  
pp. 293-296 ◽  
Author(s):  
Erica R. Thaler ◽  
Donald C. Lanza ◽  
David W. Kennedy
Keyword(s):  
Optic Nerve ◽  
Optic Neuropathy ◽  
Traumatic Optic Neuropathy ◽  
Nerve Decompression ◽  
Optic Nerve Decompression

Bilateral endoscopic optic nerve decompression in an infant with osteopetrosis

2019 ◽  
Vol 23 (1) ◽  
pp. 40-42 ◽  
Author(s):  
Anagha Medsinge ◽  
Christin Sylvester ◽  
Elizabeth Tyler-Kabara ◽  
Susan Tonya Stefko
Keyword(s):  
Optic Nerve ◽  
Nerve Decompression ◽  
Optic Nerve Decompression

Computed Tomography Anatomy of the Optic Canal

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P74-P74 ◽  
Author(s):  
Catherine K Hart ◽  
Lee A Zimmer
Keyword(s):  
Computed Tomography ◽  
Optic Nerve ◽  
Sphenoid Sinus ◽  
Optic Canal ◽  
Canal Wall ◽  
Nerve Decompression ◽  
Computed Tomography Images ◽  
Optic Nerve Decompression ◽  
Wide Range ◽  
Potential Area

Objective (1) Analyze the radiographic anatomy of the optic canal in relationship to the sphenoid sinus. (2) Understand the role variation in optic canal anatomy may have in the variability of outcomes in optic nerve decompression. Methods Fine cut computed tomography images of the sinuses were obtained with an IRB waiver. Optic canal dimensions were measured on sinus computed tomography images of 96 patients. 191 optic canals were analyzed (111 females, 80 males). Student T-test calculations were performed for statistical analysis on computer software. Results The average medial canal wall length was 1.48 centimeters (range 0.7–2.3). The length in males was 1.61 centimeters (1.1–2.3) as compared to 1.39 centimeters (0.7–2.0) in females (p=8.0–7). The average degree of exposure of the optic canal exposed to the sphenoid sinus was 101.3 degrees (56–176). The degree of exposure was 105.6 in males versus 98.2 in females (p=.01). The potential area of canal exposed to the sphenoid sinus was 0.66 centimeters squared or 28% of the total surface area. The potential area exposed to the sphenoid sinus in males was 0.76cm2 (28%) and 0.58 centimeters squared (27%) in females. Conclusions A wide range in medial canal wall length and exposure of the bony optic canal to the sphenoid sinus exists on CT images. The variation in medial canal wall length and in optic canal exposure to the sphenoid sinus may contribute to the variability in success rates of endoscopic optic nerve decompression for optic neuropathy.

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