Arachnoiditis of the Optic Nerve in the Optic Canal and Orbit

1951 ◽  
Vol 34 (4) ◽  
pp. 643 ◽  
Author(s):  
Alice R. Deutsch
Keyword(s):  
Optic Nerve ◽  
Optic Canal

scholarly journals Transsphenoidal Optic Canal Decompression for Traumatic Optic Neuropathy Assisted by a Computed Tomography Image Postprocessing Technique

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
J. Li ◽  
Q. S. Ran ◽  
B. Hao ◽  
X. Xu ◽  
H. F. Yuan
Keyword(s):  
Optic Nerve ◽  
Sphenoid Sinus ◽  
Uncinate Process ◽  
Medial Wall ◽  
Optic Canal ◽  
Wide Field ◽  
Anatomical Landmarks ◽  
Invasive Approach ◽  
Ethmoidal Sinus ◽  
Less Invasive

The endoscopic transethmoidal approach is favored for the lack of external scars, a wide field of view, and rapid recovery time. But the effect of iatrogenic trauma should not be ignored due to the removal of the uncinate process and anterior and posterior ethmoidal sinus. Anatomically, the optic nerve is close to the sphenoid sinus and Onodi cell. In order to preserve the uncinate process and ethmoidal sinus, we perform endoscopic transsphenoidal optic canal decompression (ETOCD), which is less invasive. However, the anatomy of sphenoid sinus is quite variable, and the anatomical landmarks are rare. Therefore, identifying the position of optic canal is particularly important during surgery. To solve this, we use a postprocessing technique to identify the position of the optic nerve and internal carotid artery on the sphenoid sinus wall. Our results find that VA in 13 patients improved, with a total improve rate of 59.1%. No serious complications were found. We also found that the length of optic canal is different and the medial wall of the optic canal was the longest (p<0.05). The middle section of the optic canal is the narrowest, which was significantly different from cranial mouth and orbital mouth (p<0.05). We assumed that decompression may not require removal of all medial wall. If we remove the length of the shortest wall on the medial wall of the optic canal, the compression may be relieved. Thus, ETOCD was a feasible, safe, effective, and less-invasive approach for patients with TON. The CT postprocessing imaging facilitated recognition of the optic canal during surgery. The decompression length of the medial wall may not need to be completely removed, especially near the cranial mouth.

Ultrasonic bone curettage for optic canal unroofing and anterior clinoidectomy

2006 ◽  
Vol 104 (4) ◽  
pp. 621-624 ◽  
Author(s):  
Han Soo Chang ◽  
Masahiro Joko ◽  
Joon Suk Song ◽  
Kiyoshi Ito ◽  
Tatsushi Inoue ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Visual Outcome ◽  
Optic Canal ◽  
Internal Auditory Meatus ◽  
Major Morbidity ◽  
Anterior Clinoidectomy ◽  
Optic Nerve Damage ◽  
Bone Removal ◽  
Visual Status ◽  
Optic Canal Unroofing

✓Extradural unroofing of the optic canal and subsequent mobilization of the optic nerve is a useful technique in the surgical treatment of parasellar tumors; however, the drilling procedure itself is associated with the risk of optic nerve damage. A safer technique would certainly be beneficial. The ultrasonic bone curette is a device developed in Japan for safer bone removal. Its use in intradural anterior clinoidectomy and opening of the internal auditory meatus has been reported before. In this article the authors describe their experience in using this device for extradural unroofing of the optic canal in patients with parasellar tumors. Between March 2002 and November 2004, the aforementioned technique was used in the treatment of eight patients with parasellar tumors. After undertaking a frontotemporal craniotomy and orbital osteotomy, an ultrasonic bone curette was used to unroof the optic canal via an epidural approach; in five cases anterior clinoidectomy was added subsequently. Using an ultrasonic bone curette, unroofing of the optic canal was completed safely and required much less expertise than that required for standard drilling. The mortality and major morbidity rates were 0%. The visual function outcome was satisfactory, with the overall visual status improving in all seven patients in whom this symptom was present preoperatively. The ultrasonic bone curette makes the unroofing of the optic canal safer and easier, possibly improving the visual outcome of patients undergoing surgery for parasellar tumors.

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.

Visual Outcome of Tuberculum Sellae Meningiomas after Extradural Optic Nerve Decompression

Neurosurgery ◽  
2006 ◽  
Vol 59 (3) ◽  
pp. 570-576 ◽  
Author(s):  
Tiit Mathiesen ◽  
Lars Kihlström
Keyword(s):  
Cerebrospinal Fluid ◽  
Optic Nerve ◽  
Diabetes Insipidus ◽  
Visual Outcome ◽  
Optic Canal ◽  
Visual Deterioration ◽  
Nerve Decompression ◽  
Visual Outcomes ◽  
Tuberculum Sellae

Abstract OBJECTIVE: Meningiomas of the tuberculum sellae have a close relationship with the optic apparatus. Even modern series show a 10 to 20% risk of visual deterioration after surgery. We have attempted to improve visual outcome by extradural decompression of the optic canal and anterior clinoid process, followed by intradural release of the optic nerve; this study provides an analysis of visual outcomes with this approach. METHODS: Treatment, histopathology, and follow-up data of 29 consecutive patients undergoing surgery for tuberculum sellae meningiomas with initial release of the optic nerve were prospectively collected. RESULTS: Radical tumor removal was possible in all 23 patients with primary tumors and in three out of six patients with recurrent tumors. All patients but two of the worst affected with preoperative visual compromise improved from surgery; there were no instances of visual deterioration. Five patients with normal preoperative vision remained intact and visual improvement was 22 (91%) out of 24 patients in the remaining patients. In total, 13 patients (42%) had completely normal vision at follow-up. Mainly patients younger than 60 years experienced complete normalization after surgery. Two patients underwent transsphenoidal surgery for cerebrospinal fluid leaks. Postoperative endocrinological symptoms were temporary diabetes insipidus in one patient and permanent diabetes insipidus in another patient undergoing elective sectioning of the pituitary stalk because of a recurrent tumor with invasive growth into the stalk. CONCLUSION: Adding early optic nerve decompression by extradural clinoidectomy and optic canal unroofing to a frontopterional approach seemed to improve visual outcomes because there were no instances of visual deterioration. Simpson Grade 1 to 2 removal was possible in all patients with primary surgery, whereas recurrent cases could only be treated with lower grades of radicality. Radical removal, however, required readiness to reoperate for cerebrospinal fluid leakage at the site of the drilled tumor origin in bone.

Fracture line in post head injury optic nerve damage

1991 ◽  
Vol 105 (3) ◽  
pp. 203-204 ◽  
Author(s):  
Sadhana R. Nayak ◽  
M. V. Kirtane ◽  
M. V. Ingle
Keyword(s):  
Optic Nerve ◽  
Head Injury ◽  
Blunt Trauma ◽  
Head Injuries ◽  
Nerve Damage ◽  
Fracture Line ◽  
Optic Canal ◽  
Optic Nerve Damage

AbstractDiminution of vision following head injuries involving the optic canal is not uncommon. In order to find how a blunt trauma to the frontotemporal region produced damage to the optic nerve inits canalicular this study was conducted on cadaveric skulls and its results are described.

Optic canal syndrome due to posterior ethmoid sinus mucocele

1986 ◽  
Vol 65 (6) ◽  
pp. 871-873 ◽  
Author(s):  
Chung P. Yue ◽  
Kirpal S. Mann ◽  
Fu L. Chan
Keyword(s):  
Optic Nerve ◽  
Computerized Tomography ◽  
Ethmoid Sinus ◽  
Optic Canal ◽  
Content Type ◽  
Anatomical Relationship ◽  
Relationship Of ◽  
Canal Syndrome ◽  
Fine Print

✓ A case of mucocele of the posterior ethmoid sinus presenting as unilateral blindness without pain, proptosis, or diplopia is reported. Computerized tomography (CT) demonstrated the precise anatomical relationship of the mucocele to the optic nerve inside the optic canal. It is proposed to use the term “optic canal syndrome” for patients with such clinical and CT presentation. Combined transcranial excision and transnasal drainage resulted in dramatic recovery of vision.

scholarly journals Contralateral Eyebrow Approach for Unilateral Suprasellar Meningioma

2018 ◽  
Vol 79 (S 02) ◽  
pp. S215-S217
Author(s):  
Sorin Aldea ◽  
Stéphan Gaillard
Keyword(s):  
Optic Nerve ◽  
Visual Loss ◽  
Complete Removal ◽  
Optic Canal ◽  
Line Of Sight ◽  
Visual Recovery ◽  
Postoperative Mri ◽  
Working Distance ◽  
Dural Opening ◽  
Distinct Features

AbstractUnilateral suprasellar meningiomas have distinct features compared to other midline tumors, as they may produce severe visual symptoms even if small due to an early involvement of the optic canal. Surgical treatment of these tumors from an ipsilateral approach is challenging, as the tumor is covered by the optic nerve that needs to be mobilized to access the optic canal extension. A contralateral approach allows a direct line of sight to the tumor despite a longer working distance. We report the case of a 49-year-old patient presenting with unilateral visual loss related to a left suprasellar meningioma extending to the left optic canal and displacing the optic nerve laterally. Through a right eyebrow approach, a 2.5/2 cm supraorbital bone flap was raised and the orbital floor was thoroughly flattened. After dural opening, the carotid cistern was opened and CSF evacuated allowing a surgery without fixed retractors. The intracranial part of the tumor was removed, but the optic nerve seemed to be still displaced by the intracanalicular part. Under copious irrigation, the medial part of the optic canal was drilled, the dura incised, and the tumor removed. Postoperative course was favorable and the patient made a complete visual recovery. Postoperative MRI showed complete removal of the tumor. We present different surgical steps and discuss the nuances of the procedure. The contralateral eyebrow approach is an interesting addition to the surgical armamentarium and should be discussed for unilateral suprasellar tumors.The link to the video can be found at: https://youtu.be/2LTEOaGoKzo.

scholarly journals Optic nerve cysticercosis in the optic canal

1999 ◽  
Vol 77 (1) ◽  
pp. 107-109 ◽  
Author(s):  
Nita Gurha ◽  
Archana Sood ◽  
Jawahar Dharand ◽  
Sanjeev Gupta
Keyword(s):  
Optic Nerve ◽  
Optic Canal

scholarly journals Ultra-Early Optic Nerve Decompression for the Resection of Anterior Clinoidal Meningioma

2018 ◽  
Vol 79 (S 02) ◽  
pp. S231-S232
Author(s):  
Soichi Oya ◽  
Toru Matsui
Keyword(s):  
Optic Nerve ◽  
Surgical Resection ◽  
Surgical Techniques ◽  
Magnetic Resonance Images ◽  
Optic Canal ◽  
Decompression Surgery ◽  
Nerve Decompression ◽  
Visual Deficits ◽  
Optic Nerve Decompression ◽  
The Right

AbstractImprovement in vision is one of the main goals of surgery for anterior clinoidal meningiomas with visual deficits. Early optic nerve decompression surgery has been advocated in previous studies to achieve the best visual outcome. Through this video, the authors describe their surgical techniques to decompress the optic nerve at the very early stage of surgery. A 35-year-old patient presented with subjective blurry vision in the right eye over the last 8 months. Magnetic resonance images showed a 3.2-cm meningioma arising at the right anterior clinoid. Preoperative ophthalmological test was within the normal range, but the patient wished to have surgical resection after a detailed discussion of benefits and risks related to surgical resection. The surgical strategy consisted of the right lateral subfrontal approach that includes a standard right frontotemporal craniotomy, extradural anterior clinoidectomy, and early optic nerve decompression prior to tumor resection. The tumor was divided into compartments defined by the arteries and resected. Simpson grade II resection was achieved without complications. The patient's symptoms disappeared. In anterior clinoidal meningiomas that cause visual deficits, the optic nerve is assumed very vulnerable to any further injuries related to the operative maneuver. Ultra-early optic nerve decompression can be performed in anterior clinoidal meningiomas regardless of their size by extradural unroofing of the optic canal and sectioning of the optic canal sheath, which we believe contributes to better visual improvement.The link to the video can be found at: https://youtu.be/RIFi4ecWAhQ.

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