Endoscopic Optic Nerve Decompression Through Supraorbital Keyhole Extradural Approach: A Cadaveric Study

Area of Science:

• Neurosurgery
• Ophthalmology
• Minimally Invasive Surgery

Background:

• Various optic nerve decompression techniques exist, each with limitations.
• Endoscopic approaches offer potential advantages in visualization and access.

Purpose of the Study:

• To evaluate the feasibility of endoscopic optic nerve decompression using a supraorbital keyhole extradural approach.
• To assess the safety and efficacy of this minimally invasive technique.

Main Methods:

• Ten adult cadaveric heads were utilized for the study.
• A 4-mm rigid endoscope (0- and 30-degree) was employed for extradural optic nerve decompression.
• Measurements of the optic canal and surrounding structures were recorded.

Main Results:

• The supraorbital keyhole approach provided clear visualization of the sphenoid ridge, anterior clinoid process, optic canal roof, and falciform ligament.
• Successful decompression was achieved by removing the optic canal roof and lateral wall, and incising the falciform ligament and optic sheath.
• Key anatomical distances were measured, including the distance from the zygomatic process to the optic canal (59.32 ± 2.27 mm) and from the optic canal to the internal carotid artery (3.80 ± 0.93 mm).

Conclusions:

• Endoscopic optic nerve decompression through the supraorbital keyhole extradural approach is feasible and provides a clear surgical view.
• This technique represents a potentially safe and minimally invasive option for optic nerve decompression.