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.

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.

Extradural Anterior Clinoidectomy as an Alternative Approach for Optic Nerve Decompression: Anatomic Study and Clinical Experience

2006 ◽  
Vol 59 (suppl_4) ◽  
pp. ONS-253-ONS-262 ◽  
Author(s):  
Yang Yang ◽  
Hongjie Wang ◽  
Yi Shao ◽  
Zenghua Wei ◽  
Shugan Zhu ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Neuropathy ◽  
Optic Canal ◽  
Falciform Ligament ◽  
Traumatic Optic Neuropathy ◽  
Pterional Craniotomy ◽  
Anterior Clinoidectomy ◽  
Nerve Decompression ◽  
Optic Nerve Decompression ◽  
Alternative Approach

Abstract OBJECTIVE: We introduce pterional craniotomy extradural anterior clinoidectomy as a new alternative approach for optic nerve decompression in patients with traumatic optic neuropathy. METHODS: Intracranial structures pertinent to pterional craniotomy extradural anterior clinoidectomy were carefully studied in 10 dry craniums and 10 cranial bases with dura mater. Important parameters of these structures were measured. Stepwise dissections simulating pterional craniotomy extradural anterior clinoidectomy were performed in 20 cadaver heads bilaterally. Pterional craniotomy extradural anterior clinoidectomy was then applied to 12 patients (13 eyes) with traumatic optic neuropathy and severe visual dysfunction. RESULTS: The anatomic features and their variations of optic canal, ophthalmic artery, falciform ligament, and Zinn's ring (annular tendon) were studied and measured in detail. Extensive opening of the optic canal and optic nerve sheath was successfully achieved in all 12 patients without major surgical complications. Significant visual acuity improvement occurred in eight (nine eyes) out of our 12 patients after surgery. The surgical techniques and advantages of pterional craniotomy extradural anterior clinoidectomy for optic nerve decompression are presented and discussed in detail. @@CONCLUSION:@@ Pterional craniotomy extradural anterior clinoidectomy is a promising new alternative approach for optic nerve decompression in patients with traumatic optic neuropathy.

Endoscopic Endonasal Optic Nerve Decompression for Benign Pathology of the Optic Canal

2014 ◽  
Vol 75 (S 02) ◽  
Author(s):  
T. Deklotz ◽  
S. Stefko ◽  
J. Fernandez-Miranda ◽  
P. Gardner ◽  
C. Snyderman ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Canal ◽  
Endoscopic Endonasal ◽  
Nerve Decompression ◽  
Optic Nerve Decompression ◽  
Benign Pathology

scholarly journals Nursing Research of Optic Canal Decompression Operation under Nasal Endoscopic Medical Treatment Based on Intelligent Internet of Things for Traumatic Vision Disorders

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Yu Liu ◽  
Yanchun Zhao ◽  
Xia Gong ◽  
Ying Zhang
Keyword(s):  
Optic Nerve ◽  
Internet Of Things ◽  
Relevant Literature ◽  
Age Groups ◽  
Optic Canal ◽  
Decompression Surgery ◽  
Vision Disorders ◽  
Nerve Decompression ◽  
Optic Nerve Decompression ◽  
Visual Disturbances

Traumatic vision is an important factor that causes people to have a vision. In our country, the vast majority of vision is caused by trauma. To understand the role of optic nerve decompression in the treatment of traumatic visual disturbances based on the pathological states of traumatic visual disturbances and intelligent Internet of tumors medical nasal endoscopy optic nerve decompression. This article collects relevant information by investigating patients, investigating relevant literature, interviewing professionals, etc., constructing a case template and using a comprehensive quantitative and qualitative analysis method to create a damage assessment matrix. The results of the study found that most traumatic vision disorders occur in the young and middle-aged stage, which is more than three times that of other age groups. The permanent blindness rate of patients reaches 8%, which is extremely harmful. Optic canal decompression surgery can play a great role in the treatment of patients. It can greatly reduce the patient’s neurological damage. The effect is about 30% higher than that of general treatment methods, and it can also play a certain role in the prognosis of rehabilitation. It can effectively prevent related postoperative complications. This shows that optic canal decompression in the treatment of traumatic vision disorders should attract people’s attention and increase research and development efforts and promotion efforts so that optic canal decompression can be used in the diagnosis and treatment of patients with traumatic vision disorders based on smart Internet of things China can play a greater role.

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.

Endoscopic Endonasal Optic Nerve Decompression for Benign Pathology of the Optic Canal

2014 ◽  
Vol 75 (S 01) ◽  
Author(s):  
T. DeKlotz ◽  
S. Stefko ◽  
J. Fernandez-Miranda ◽  
P. Gardner ◽  
C. Snyderman ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Canal ◽  
Endoscopic Endonasal ◽  
Nerve Decompression ◽  
Optic Nerve Decompression ◽  
Benign Pathology

Outcome of Endoscopic Optic Nerve Decompression for Traumatic Optic Neuropathy

2020 ◽  
Vol 130 (1) ◽  
pp. 56-59
Author(s):  
Jingwen Sun ◽  
Xiaojing Cai ◽  
Wentao Zou ◽  
Jiaxiong Zhang
Keyword(s):  
Optic Nerve ◽  
Optic Neuropathy ◽  
Optic Canal ◽  
Partial Recovery ◽  
Traumatic Optic Neuropathy ◽  
Irreversible Damage ◽  
Permanent Disability ◽  
Nerve Decompression ◽  
Optic Nerve Decompression ◽  
Residual Vision

Objective: This study aimed to evaluate the outcomes of endoscopic optic nerve decompression (EOND) for adults with traumatic optic neuropathy (TON) and seek factors that might affect surgery outcomes. Methods: From January 2016 to June 2019, 16 adults diagnosed with TON, who underwent endoscopic trans-ethmosphenoid optic canal decompression, were reviewed. All the patients were treated with steroids before the surgery. The main outcome measure was an improvement in visual acuity (VA) after treatment. Results: Eight (50.0%) patients had residual vision before the surgery, while eight (50.0%) had no light perception. After surgical decompression, partial recovery of VA was achieved in three (18.75%) patients who were operated within 10 days and had residual vision before the surgery. However, no improvement in VA was observed for the remaining patients (81.25%) who were operated more than 10 days after injuries. Conclusions: EOND is beneficial for TON not responding to steroid therapy and can prevent permanent disability if earlier intervention is done prior to irreversible damage to the nerve. Endoscopic optic nerve surgery can decompress the traumatic and edematous optic nerve with proper exposure of optic canal and orbital apex without any major complications. The operation timing and residual vision are important factors affecting outcomes.

scholarly journals Optic nerve decompression in Craniofacial fibrous dysplasia involving optic canal: An experience at AIIMS, New Delhi

2019 ◽  
Vol 24 (2) ◽  
pp. 94-104
Author(s):  
Bashir Ahmed ◽  
Alok Thakkar ◽  
SM Nurul Irfan
Keyword(s):  
Optic Nerve ◽  
Visual Impairment ◽  
Fibrous Dysplasia ◽  
Optic Canal ◽  
New Delhi ◽  
Medical Sciences ◽  
Ethmoid Bone ◽  
Nerve Decompression ◽  
Visual Improvement ◽  
Optic Nerve Decompression

Background: Gradual progression of craniofacial fibrous dysplasia frequently involves sphenoid and ethmoid bone results encasement of optic canal which leads to visual impairment to complete blindness Methods: Retrospective study was carried out at All India Institute of Medical Sciences on hospital records of 16 cases of craniofacial fibrous dysplasia operated for optic canal involvement with or without visual impairment with an objective to discuss about the indications, suitable timing and outcome of optic nerve decompression in cases of optic canal involvement. Results: Out of 16 cases, 56.25% were female with mean age 13.06 years. 15 patients had Idiopathic Fibrous dysplasia and 01 had Cranio-metaphyseal dysplasia. 62.5% were polyostotic and 37.5% were monostotic with 62.5% of optic neuropathy. Bilateral lesion occurred in 03 patients. Optic nerve decompression was done for curative treatment in 62.5% and for prophylactic in 37.5% cases. Post-operative visual improvement occurred in 90% patients and in no patient vision was deteriorated. Conclusion: Prophylactic decompression can be carried out in expert hand for involvement of optic canal in craniofacial fibrous dysplasia for prevention of future visual impairment  Bangladesh J of Otorhinolaryngology; October 2018; 24(2): 94-104

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