title: Endoscopic optic nerve fenestration amongst pediatric idiopathic intracranial hypertension: a new surgical option.
abstract: OBJECTIVE
  To assess the effectiveness of transnasal trans-sphenoid endoscopic optic nerve fenestration for the reversal of vision loss in pediatric idiopathic intracranial hypertension (IIH).
  
  
  METHODS
  This is a single center observational retrospective case series. Fifteen diagnosed pediatric patients of IIH satisfying the modified Dandy criteria and reported to the out-patient services of otolaryngology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India were included in this study. All children underwent thorough clinical examination, complete neuro-ophthalmological work up including visual acuity (V/A), visual field charting(V/F), fundus venogram and radiological work up with MRI for special optic nerve sections in sagittal reconstruction. cerebro-spinal fluid pressure (CSF) measured pre operatively for all children. Standard endoscopic optic nerve sheath fenestration was performed on all children. Visual improvement was assessed by comparing pre-operative ophthalmological findings.
  
  
  RESULTS
  Improvement in vision was taken as a positive outcome. Vision improved in all except two children, who had pre-existing optic nerve atrophy.
  
  
  CONCLUSIONS
  Endoscopic optic nerve fenestration is an effective minimally invasive procedure to revert visual loss in pediatric Idiopathic Intracranial Hypertension.
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India. Electronic address: pgimerent@yahoo.in.
authors.forename: Ashok K
authors.initials: AK
authors.lastname: Gupta
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
authors.forename: Karan
authors.initials: K
authors.lastname: Gupta
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
authors.forename: Satheesh K
authors.initials: SK
authors.lastname: Sunku
authors.affiliation: Department of Neurology, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
authors.forename: Manish
authors.initials: M
authors.lastname: Modi
authors.affiliation: Department of Ophthalmology, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
authors.forename: Amod
authors.initials: A
authors.lastname: Gupta
mesh_terms: D000293:Adolescent; D001766:Blindness / Q000209:etiology / Q000601:surgery*; D002648:Child; D004724:Endoscopy / Q000379:methods*; D005074:Evoked Potentials, Visual; D005260:Female; D005654:Fundus Oculi; D006261:Headache; D006801:Humans; D007194:India; D008279:Magnetic Resonance Imaging; D008297:Male; D019721:Ophthalmoscopes; D009900:Optic Nerve / Q000601:surgery*; D011559:Pseudotumor Cerebri / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D014792:Visual Acuity
keywords: Idiopathic intracranial hypertension; Optic nerve fenestration; Pediatric