Combined transconjunctival/intranasal endoscopic approach to the optic canal in traumatic optic neuropathy.
Surgical decompression of the optic canal is indicated in patients with traumatic optic neuropathy who fail to respond to corticosteroids. Traditional surgical approaches to the orbital apex have been effective in achieving optic nerve decompression but require either a craniotomy, provide limited exposure with late identification and protection of the optic nerve, or require external incisions. The combined transconjunctival/intranasal endoscopic approach to the optic canal offers sufficient exposure, allows early identification and protection of the optic nerve, provides space for the use of multiple surgical instruments, obviates a craniotomy and external incisions, and can be performed quickly with minimal morbidity. The technique of combined transconjunctival/intranasal endoscopic optic nerve decompression will be described and the experience with nine cases will be presented.
Kuppersmith
R B
RB
Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, TX 77030, U.S.A.
Alford
E L
EL
Patrinely
J R
JR
Lee
A G
AG
Parke
R B
RB
Holds
J B
JB
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D016063:Blood Loss, Surgical; D003228:Conjunctiva / Q000601:surgery*; D003399:Craniotomy; D004564:Electrocoagulation / Q000295:instrumentation / Q000379:methods; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000601:surgery; D009666:Nose / Q000601:surgery*; D009900:Optic Nerve / Q000601:surgery; D009901:Optic Nerve Diseases / Q000209:etiology / Q000601:surgery; D020221:Optic Nerve Injuries; D009915:Orbit / Q000601:surgery*; D012189:Retrospective Studies; D012887:Skull Fractures / Q000150:complications; D013100:Sphenoid Bone / Q000601:surgery*; D013101:Sphenoid Sinus / Q000601:surgery; D013997:Time Factors; D014420:Turbinates / Q000601:surgery; D014786:Vision Disorders / Q000601:surgery
D000305:Adrenal Cortex Hormones