Endoscopic Optic Nerve Decompression: Indications, Technique, Results

AbstractPurpose of ReviewFor decades, treatment of compressive optic nerve neuropathy was conservative and involved the intravenous application of high-dose corticoids, which was combined with nerve growth factors in later years. If surgery was considered, transcranial and transfacial access to the orbital apex and the optic nerve were achieved using classical approaches. Over the past decade, endonasal endoscopic procedures have increasingly come into force, based on favorable experiences with functional endoscopic sinus surgery and as a result of innovative developments in endoscopy and image guidance. The purpose of this review is to address the latest literature in this field with regard to the indications, techniques, results, and complications associated with this procedure.Recent FindingsThere are basically two approaches for endoscopic optic nerve decompression: the extradural supraorbital “keyhole” approach, which provides access to the optic nerve canal roof and which is usually performed by neurosurgeons, and the endonasal endoscopic approach, which is widely used by otorhinolaryngologists. The development and application of endonasal endoscopic surgery was only possible with e xtensive knowledge of the topographic anatomy. The most important anatomical landmarks and topography have been described based on either cadaveric or CT scan studies, and include the opticocarotid recess, the distance between the optic nerve canal and the internal carotid artery, the op...
Source: Current Otorhinolaryngology Reports - Category: ENT & OMF Source Type: research