Ivan Cabrilo1, Neil L Dorward2. 1. Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK. iv.cabrilo@gmail.com. 2. Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK.
Abstract
BACKGROUND: The endoscopic endonasal approach for optic nerve decompression is suited for the management of non-traumatic optic neuropathy but remains underreported, presumably due to transcranial approaches still being favoured at individual centres. METHOD: The optic canal is approached endoscopically and transsphenoidally through the contralateral nostril. Its inferomedial wall is opened using an irrigated diamond drill, and neuronavigation is used to confirm anatomical bearings. CONCLUSION: This technique provides rapid and easy access to the inferomedial aspect of the optic canal and nerve. Optic nerve decompression through this approach is associated with low morbidity and should be considered as an alternative to transcranial approaches.
BACKGROUND: The endoscopic endonasal approach for optic nerve decompression is suited for the management of non-traumatic optic neuropathy but remains underreported, presumably due to transcranial approaches still being favoured at individual centres. METHOD: The optic canal is approached endoscopically and transsphenoidally through the contralateral nostril. Its inferomedial wall is opened using an irrigated diamond drill, and neuronavigation is used to confirm anatomical bearings. CONCLUSION: This technique provides rapid and easy access to the inferomedial aspect of the optic canal and nerve. Optic nerve decompression through this approach is associated with low morbidity and should be considered as an alternative to transcranial approaches.
Entities:
Keywords:
Skull base surgery;Endoscopic endonasal approach;Transsphenoidal approach;Tumours of optic nerve sheath;Neuronavigation;Minimally invasive
Authors: Alessandro Caporlingua; Alessandro Prior; María José Cavagnaro; Graham Winston; Dayvid L C Oliveira; Shaan D Sadwhani; Glenn Alvarez Arias; Jesse N Schwalb; Melika Akhbari; Alexander I Evins; Antonio Bernardo Journal: World Neurosurg Date: 2019-04 Impact factor: 2.104