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Related Experiment Video

Updated: Jun 27, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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Transsphenoidal optic nerve decompression: an endoscopic anatomic study.

Jiping Li1, Jiadong Wang, Xiaojie Jing

  • 1Departments of Otorhinolaryngology Head and Neck Surgery, Ren Ji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

The Journal of Craniofacial Surgery
|December 23, 2008
PubMed
Summary

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This study maps the optic nerve, paranasal sinuses, and ophthalmic artery using endoscopy. Findings identify the opticocarotid recess as a key landmark for safe optic nerve decompression surgery.

Area of Science:

  • Otorhinolaryngology
  • Neurosurgery
  • Anatomy

Background:

  • Transsphenoidal optic nerve decompression requires precise anatomical knowledge.
  • Understanding the relationship between the optic nerve, paranasal sinuses, and ophthalmic artery is crucial for surgical safety.

Purpose of the Study:

  • To investigate the anatomical relationships among the optic nerve, posterior paranasal sinuses, and ophthalmic artery.
  • To establish endoscopic anatomical landmarks for optic nerve localization and ophthalmic artery injury prevention during surgery.

Main Methods:

  • The Messerklinger technique was used to access the posterior ethmoid and sphenoid sinuses in 8 adult head specimens.
  • Endoscopic identification of the opticocarotid recess, optic canal, and their relationships with surrounding structures.

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  • Detailed examination of the optic nerve-ophthalmic artery relationship at intracranial and intraorbital openings of the optic canal.

    • Main Results:

    • The opticocarotid recess was consistently identified, unlike the optic nerve protuberance.
    • Varied relationships were observed between the optic nerve and the posterior ethmoid and sphenoid sinuses.
    • The ophthalmic artery's origin was typically inferomedial to the optic nerve, coursing inferolaterally, with specific positional variations noted at the optic canal openings.

    Conclusions:

    • The opticocarotid recess serves as a reliable endoscopic landmark for optic nerve decompression.
    • Knowledge of the optic nerve, paranasal sinus, and ophthalmic artery spatial arrangement is vital for surgical planning.
    • Awareness of the ophthalmic artery's course relative to the optic nerve is essential to prevent intraoperative injury.