Endoscopic endonasal trans-sphenoidal optic nerve decompression for traumatic optic neuropathy--technical note

Area of Science:

• Neurosurgery
• Ophthalmology
• Otolaryngology

Background:

• Traumatic optic neuropathy (TON) can lead to significant vision loss.
• Traditional surgical approaches may require brain retraction, posing additional risks.
• Endoscopic endonasal trans-sphenoidal approach offers a minimally invasive alternative.

Purpose of the Study:

• To evaluate the safety and efficacy of the endoscopic endonasal trans-sphenoidal approach for optic nerve decompression in patients with TON.
• To assess visual function outcomes and surgical complications.

Main Methods:

• Three patients with TON underwent endoscopic endonasal trans-sphenoidal optic canal decompression.
• A navigation system was utilized to guide the surgical approach.
• Surgical decompression targeted the optic canal, particularly near the opticocarotid recess.

Main Results:

• Adequate decompression of the optic canal was achieved in all three patients.
• Two patients demonstrated improvement in visual function post-surgery.
• No surgical complications were reported in any of the treated patients.

Conclusions:

• Endoscopic endonasal trans-sphenoidal optic canal decompression is a potentially safe and effective strategy for select TON patients.
• This technique allows for optic nerve decompression without the need for brain retraction.
• Further studies in carefully selected patients are warranted to confirm these findings.