title: Endoscopic optic canal decompression for compressive optic neuropathy.
abstract: Compressive optic neuropathy is a rare condition that may be caused by trauma or non-traumatic events. Endoscopic techniques have evolved to provide an easier surgical approach to decompression. The aim of this study was to determine the endoscopic anatomy of the orbital apex and to identify the optimal targets for endoscopic optic nerve decompression. We report five patients with endoscopic optic nerve decompression: two with traumatic optic neuropathies, two with fibrous dysplasias, and one with chordoma. For these lesions, the major treatment concern was removal of the bony structures around the optic nerve. All compressive lesions were removed effectively via an endoscopic endonasal route. Following endoscopic optic nerve decompression, three patients had markedly improved visual acuity and fields of vision, one patient had improved fields of vision without change in visual acuity, and one patient had improved visual acuity alone. There were no operative complications. Adequate exposure of the intracanalicular portion of the optic nerve was essential for effective decompression, and to achieve this, decompression of the roof as well as medial wall of the intracanalicular portion was critical. We conclude that endoscopic optic canal decompression is a minimally invasive, safe, and efficient treatment for compressive optic neuropathy regardless of etiology.
authors.affiliation: Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 135-710 Seoul, Republic of Korea. kds026@skku.edu
authors.forename: Doo-Sik
authors.initials: DS
authors.lastname: Kong
authors.forename: Hyung Jin
authors.initials: HJ
authors.lastname: Shin
authors.forename: Hyo Yeol
authors.initials: HY
authors.lastname: Kim
authors.forename: Seung Kyu
authors.initials: SK
authors.lastname: Chung
authors.forename: Do-Hyun
authors.initials: DH
authors.lastname: Nam
authors.forename: Jung-Il
authors.initials: JI
authors.lastname: Lee
authors.forename: Kwan
authors.initials: K
authors.lastname: Park
authors.forename: Jong Hyun
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D019299:Decompression, Surgical / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D009900:Optic Nerve / Q000601:surgery*; D009901:Optic Nerve Diseases / Q000601:surgery*; D020221:Optic Nerve Injuries / Q000601:surgery; D016896:Treatment Outcome