Microscopic intranasal decompression of the optic nerve.

Area of Science:

• Ophthalmology
• Neurosurgery
• Microsurgery

Background:

• Optic nerve trauma can lead to visual impairment, sometimes without associated canal fractures.
• Edema-induced circular disturbances may contribute to reversible visual loss.
• Previous surgical approaches for optic nerve decompression have limitations, including cosmetic concerns and suboptimal visualization.

Purpose of the Study:

• To describe the methodology of intranasal optic nerve decompression using a surgical microscope.
• To evaluate the efficacy and safety of this technique in patients with optic nerve trauma.
• To compare the intranasal approach with extranasal and transantral methods.

Main Methods:

• Utilized a surgical microscope for intranasal optic nerve decompression.
• Employed a self-retaining retractor speculum for enhanced visualization during microsurgery.
• Performed the procedure in five cases of optic nerve trauma, including pediatric patients.

Main Results:

• The intranasal approach provided superior, less distorted views compared to extranasal or transantral routes.
• Microsurgery facilitated improved visualization and reliable surgical procedures.
• The technique addressed cosmetic concerns associated with alternative surgical methods.

Conclusions:

• Intranasal optic nerve decompression is a viable and effective treatment for optic nerve trauma, particularly when canal fractures are absent.
• This minimally invasive approach offers cosmetic benefits and improved surgical visualization.
• Early intervention with this technique can accelerate visual improvement following trauma without significant patient burden.