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Chen F, Zuo K, Feng S, et al. A modified surgical procedure for endoscopic optic nerve decompression for the treatment of traumatic optic neuropathy. N Am J Med Sci. 2014;6(6):270-3doi: 10.4103/1947-2714.134372.
Chen, F., Zuo, K., Feng, S., Guo, J., Fan, Y., Shi, J., & Li, H. (2014). A modified surgical procedure for endoscopic optic nerve decompression for the treatment of traumatic optic neuropathy. North American journal of medical sciences, 6(6), 270-3. https://doi.org/10.4103/1947-2714.134372
Chen, Fenghong, et al. "A modified surgical procedure for endoscopic optic nerve decompression for the treatment of traumatic optic neuropathy." North American journal of medical sciences vol. 6,6 (2014): 270-3. doi: https://doi.org/10.4103/1947-2714.134372
Chen F, Zuo K, Feng S, Guo J, Fan Y, Shi J, Li H. A modified surgical procedure for endoscopic optic nerve decompression for the treatment of traumatic optic neuropathy. N Am J Med Sci. 2014 Jun;6(6):270-3. doi: 10.4103/1947-2714.134372. PMID: 25006562; PMCID: PMC4083528.
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N Am J Med Sci. 2014 Jun;6(6):270-3. doi: 10.4103/1947-2714.134372.

A modified surgical procedure for endoscopic optic nerve decompression for the treatment of traumatic optic neuropathy.

North American journal of medical sciences

Fenghong Chen, Kejun Zuo, Shaoyan Feng, Jiebo Guo, Yunping Fan, Jianbo Shi, Huabin Li

Affiliations

  1. Allergy and Cancer Center, Otorhinolaryngology Hospital, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
  2. Department of Otolaryngology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.

PMID: 25006562 PMCID: PMC4083528 DOI: 10.4103/1947-2714.134372

Abstract

BACKGROUND: Although the endoscopic anterior-to-posterior technique offers many advantages, the long-term effects of the iatrogenic trauma (removal of the uncinate process and anterior ethmoidal sinus) resulting from the complete ethmoidectomy procedure used to gain full access to the optic nerve canal is unknown, and sequelae such as nasal synechia and sinusitis should not be ignored.

AIMS: The aim of our study is to develop a less invasive procedure for endoscopic optic nerve decompression.

MATERIALS AND METHODS: We proposed a modified trans-sphenoidal surgical procedure for endoscopic optic nerve decompression in five patients with traumatic optic neuropathy (TON), all with high sphenoidal pneumatisation and without Onodi cellulae.

RESULTS: After performing a direct sphenoidotomy through the natural ostium of the sphenoid sinus rather than a complete ethmo-sphnoidectomy, we found that the modified approach provided adequate access to the optic nerve canal and the apex using a 45° angled endoscope. Successful decompression of the canal optic nerve was performed trans-sphenoidally in all five TON patients using an angled endoscope. No surgical complications occurred, and none of the patients suffered from anterior ethmoidal sinus or skull base damage.

CONCLUSIONS: The modified trans-sphenoidal approach is a feasible, safe, effective, and minimally invasive approach for TON patients with high sphenoidal pneumatisation and without supersphenoid-ethmoid cellulae.

Keywords: Endoscopic technique; Optic nerve decompression; Traumatic optic neuropathy

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