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Related Experiment Video

Updated: May 22, 2025

Quantification of Optic Nerve Cross Sectional Area on MRI: A Novel Protocol using Fiji Software
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Standardized Endoscopic Optic Nerve Decompression: A Comprehensive Radiological and Anatomical Study

Andrzej Sieskiewicz1, Michał Sieśkiewicz2, Bogdan Ciszek3

  • 1Department of Otolaryngology, Medical University of Bialystok, Poland.

Otolaryngologia Polska = the Polish Otolaryngology
|March 17, 2025
PubMed
Summary

Standardized endoscopic optic nerve decompression (EOND) planning using CT scans ensures precise nerve exposure. This approach minimizes risks of under or over-decompression, improving treatment consistency.

Keywords:
anatomic landmarksendoscopyoptic nerve diseasesskull basesurgical decompressiontomography

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Area of Science:

  • Neurosurgery
  • Ophthalmology
  • Medical Imaging

Background:

  • Endoscopic optic nerve decompression (EOND) indications are expanding, but a lack of standardized guidelines leads to variable nerve exposure and difficulty comparing outcomes.
  • Current practices for EOND lack uniformity, impacting the reliability and comparability of treatment effectiveness.

Purpose of the Study:

  • To propose a standardized methodology for planning and executing endoscopic optic nerve decompression (EOND).
  • To leverage radiological and anatomical data for consistent EOND procedures.

Main Methods:

  • Fifteen cadaver heads underwent EOND using non-standard oblique computed tomography (CT) reconstruction planes to map the optic canal.
  • Decompression targeted the posterior cranial aspect of the optic canal, aiming for 180-degree bone coverage.
  • Transcranial access verified decompression adequacy post-procedure.

Main Results:

  • Mean distances from decompression endpoint: 8.2 mm to orbital apex, 3.0 mm to cranial optic canal end, 0.4 mm to lateral optico-carotid recess.
  • All 30 procedures demonstrated adequate decompression coverage confirmed transcranially.
  • The method allowed precise, individualized planning for EOND.

Conclusions:

  • Non-standard oblique CT reconstruction planes facilitate accurate, patient-specific EOND planning.
  • This technique reduces the likelihood of inadequate or excessive optic nerve decompression.
  • The proposed method offers a pathway to standardize optic nerve decompression extent in endoscopic procedures.