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Fredrickson VL, Agnoletto GJ, Hollon TC, et al. Cranio-Orbital Approach for Single-Stage En Bloc Resection of Optic Nerve Glioma: Technical Note. Oper Neurosurg (Hagerstown). 2021;doi: 10.1227/ONS.0000000000000027.
Fredrickson, V. L., Agnoletto, G. J., Hollon, T. C., Kundu, B., Mortimer, V. R., & Couldwell, W. T. (2021). Cranio-Orbital Approach for Single-Stage En Bloc Resection of Optic Nerve Glioma: Technical Note. Operative neurosurgery (Hagerstown, Md.), . https://doi.org/10.1227/ONS.0000000000000027
Fredrickson, Vance L, et al. "Cranio-Orbital Approach for Single-Stage En Bloc Resection of Optic Nerve Glioma: Technical Note." Operative neurosurgery (Hagerstown, Md.) vol. (2021). doi: https://doi.org/10.1227/ONS.0000000000000027
Fredrickson VL, Agnoletto GJ, Hollon TC, Kundu B, Mortimer VR, Couldwell WT. Cranio-Orbital Approach for Single-Stage En Bloc Resection of Optic Nerve Glioma: Technical Note. Oper Neurosurg (Hagerstown). 2021 Dec 22; doi: 10.1227/ONS.0000000000000027. Epub 2021 Dec 22. PMID: 35007223.
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Oper Neurosurg (Hagerstown). 2021 Dec 22; doi: 10.1227/ONS.0000000000000027. Epub 2021 Dec 22.

Cranio-Orbital Approach for Single-Stage En Bloc Resection of Optic Nerve Glioma: Technical Note.

Operative neurosurgery (Hagerstown, Md.)

Vance L Fredrickson, Guilherme J Agnoletto, Todd C Hollon, Bornali Kundu, Vance R Mortimer, William T Couldwell

Affiliations

  1. Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA.

PMID: 35007223 DOI: 10.1227/ONS.0000000000000027

Abstract

BACKGROUND AND IMPORTANCE: There is no consensus on the optimal surgical approach for managing optic nerve gliomas. For solely intraorbital tumors, a single-stage lateral orbitotomy approach for resection may be performed, but when the nerve within the optic canal is affected, two-stage cranial and orbital approaches are often used. The authors describe their technique to safely achieve aggressive nerve resection to minimize the probability of recurrence that might affect the optic tracts, optic chiasm, and contralateral optic nerve.

CLINICAL PRESENTATION: A 28-yr-old woman presented with painless progressive vision loss, resulting in blindness. The second of 2 transorbital biopsies was diagnostic and consistent with low-grade glioma. The lesion continued to grow on serial imaging. The patient was offered a globe-sparing operative approach, with aggressive resection of the lesion to minimize the probability of tumor recurrence, which could possibly affect vision in her contralateral eye. The patient did well postoperatively, with clean tumor margins on pathological analysis and no evidence of residual on imaging. On postoperative examination, she had a mild ptosis, which was nearly resolved at her 6-wk outpatient follow-up.

CONCLUSION: This aggressive single-stage en bloc resection of an optic nerve glioma can achieve excellent tumor margins and preservation of extraocular muscle function.

Copyright © Congress of Neurological Surgeons 2021. All rights reserved.

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