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VOLUME 8 , ISSUE 3 ( September-December, 2015 ) > List of Articles

RESEARCH ARTICLE

Endoscopic Trans-ethmo-sphenoidal Optic Nerve Decompression for Traumatic Optic Neuropathy: Case Series and Review

Manish Gupta, Gavinder Singh Bindra, Ravi Vohra

Keywords : Blindness acquired,Endonasal trans-sphenoidal approach,Endoscope,Methylprednisolone,Optic canal decompression,Traumatic optic neuropathy

Citation Information : Gupta M, Bindra GS, Vohra R. Endoscopic Trans-ethmo-sphenoidal Optic Nerve Decompression for Traumatic Optic Neuropathy: Case Series and Review. Clin Rhinol An Int J 2015; 8 (3):99-103.

DOI: 10.5005/jp-journals-10013-1243

Published Online: 01-12-2015

Copyright Statement:  Copyright © 2015; The Author(s).


Abstract

Objective

To assess the visual outcome after endoscopic, endonasal trans-ethmo-sphenoidal optic nerve decompression in patients with traumatic optic neuropathy.

Materials and methods

Prospective study, at tertiary referral center. Study included 12 patients with post-traumatic indirect unilateral optic nerve injury, not responding to medical management with methylprednisolone. These patients underwent optic nerve decompression via trans-ethmo-sphenoidal route using nasal endoscope. Main outcome measure was postoperative visual acuity.

Results

Out of the 12 cases of traumatic optic neuropathy (TON) operated upon, nine had good visual outcome.

Conclusion

The endoscopic endonasal trans-sphenoidal approach can decompress the traumatized and swollen optic nerve with excellent visualization of the orbital apex and optic canal, without the morbidity associated with brain retraction as in the conventional transcranial decompression.

How to cite this article

Gupta M, Bindra GS, Vohra R. Endoscopic Trans-ethmo-sphenoidal Optic Nerve Decompression for Traumatic Optic Neuropathy: Case Series and Review. Clin Rhinol An Int J 2015;8(3):99-103.


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  1. Traumatic optic neuropathy. Int Ophthalmol Clin 1995;35:57-62.
  2. Traumatic optic neuropathies. In: Walsh and Hoyt's Clinical Neuro-Ophthalmology. 5th ed. Baltimore, Md: William & Wilkins; 1997. p. 715-739.
  3. The treatment of traumatic optic neuropathy: the international optic nerve trauma study. Ophthalmol 1999;106:1268-1277.
  4. Outcome of traumatic optic neuropathy. Comparison between surgical and nonsurgical treatment. Acta Neurochir (Wien) 1999;141:27-30.
  5. Endoscopic endo nasal transsphenoidal surgery. Neurosurg 2004;55:933-941.
  6. Traumatic optic neuropathy. A metaanalysis. Arch Otolaryngol Head Neck Surg 1996;122:389-392.
  7. WHO Chron 1979;33:275-283.
  8. Traumatic optic neuropathy. Surv Ophthalmol 1994;38:487-518.
  9. Bilateral optic nerve injury. Neurol India 1999;47:92-93.
  10. Optic nerve decompression. Otolaryngol Clin North Am 1988;21:155-169.
  11. Relationship of the optic nerve to the posterior paranasal sinuses: a CT anatomic study. Am J Neuroradiol 1996;17:669-675.
  12. Optic nerve sheath decompression: neuro pathologic, clinical and hemodynamic results and rationale. Tr Am Ophth Soc 1991;89:675-720.
  13. Traumatic optic neuropathy: visual outcome following combined therapy protocol. Arch Otolaryngol Head Neck Surg 2003; 129:1203-1206.
  14. Optic nerve disorders: role of canal and nerve sheath decompression surgery. Eye 2004;18:1169-1174.
  15. Pure endoscopic endonasal approach for pituitary adenomas: Early surgical results in 200 patients and comparison with previous microsurgical series. Neurosurg 2008;62:1006-1017.
  16. Endoscopic optic nerve decompression: the Graz experience. Laryngoscope 1998;108:873-882.
  17. Optic canal decompression: a cadaveric study of the effects of surgery. Ophthal Plast Reconstr Surg 2007;23:261-266.
  18. Surgery for optic nerve injury: should nerve sheath incision supplement osseous decompression? Skull Base 2009;19:263-272.
  19. Remyelination follows antibodyinduced central nervous system demyelination. Ann Neurol 1986;20:94-98.
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