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How I do it: the endoscopic endonasal optic nerve and orbital apex decompression
Timothée Jacquesson1, Lucie Abouaf, Moncef Berhouma
1Skull Base Surgery Unit - Department of Neurosurgery B, Pierre Wertheimer Neurological and Neurosurgical Hospital - Hospices Civils de Lyon, Lyon, France, timothee.jacquesson@neurochirurgie.fr.
Acta Neurochirurgica
|August 22, 2014
Summary
Endoscopic endonasal surgery offers a minimally invasive approach for orbital decompression, improving patient vision. This technique is beneficial for orbital tumoral diseases, though further research is needed.
Area of Science:
- Neurosurgery
- Ophthalmology
- Endoscopic Surgery
Background:
- Endoscopic endonasal surgery is expanding its indications.
- The orbital compartment is accessible via an anteromedial approach.
- Limited data exists for tumoral diseases using this route.
Purpose of the Study:
- To summarize the technique and experience with endonasal endoscopic orbital decompression.
- To evaluate the benefits for patients with orbital tumoral diseases.
Main Methods:
- Utilizing techniques and tools from pituitary surgery.
- Performing middle turbinectomy and posterior ethmoidectomy to access the medial orbital wall.
- Careful opening of the Onodi cell and lamina papyracea, followed by optic canal decompression with continuous irrigation.
Main Results:
- The technique proved beneficial for patients.
- Improvements in visual outcomes were observed.
- Pulsatile optic nerve post-decompression indicates successful decompression.
Conclusions:
- Endoscopic endonasal orbital decompression is a viable and beneficial strategy.
- Nasal and sphenoidal anatomy are critical for feasibility and risk assessment.
- Further studies are warranted to fully establish its role.
