Endoscopic Endonasal Optic Nerve Decompression for Fibrous Dysplasia.
ObjectiveTo evaluate visual outcomes and potential complications for optic nerve decompression using an endoscopic endonasal approach (EEA) for fibrous dysplasia.DesignRetrospective chart review of patients with fibrous dysplasia causing extrinsic compression of the canalicular segment of the optic nerve that underwent an endoscopic endonasal optic nerve decompression at the University of Pittsburgh Medical Center from 2010 to 2013.Main Outcome MeasuresThe primary outcome measure assessed was best-corrected visual acuity (BCVA) with secondary outcomes, including visual field testing, color vision, and complications associated with the intervention.ResultsA total of four patients and five optic nerves were decompressed via an EEA. All patients were symptomatic preoperatively and had objective findings compatible with compressive optic neuropathy: decreased visual acuity was noted preoperatively in three patients while the remaining patient demonstrated an afferent pupillary defect. BCVA improved in all patients postoperatively. No major complications were identified.ConclusionEEA for optic nerve decompression appears to be a safe and effective treatment for patients with compressive optic neuropathy secondary to fibrous dysplasia. Further studies are required to identify selection criteria for an open versus an endoscopic approach.
Department of Otolaryngology-Head and Neck Surgery, Medstar Georgetown University Hospital, Washington, District of Columbia, United States.
Timothy R
TR
DeKlotz
Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States.
S Tonya
ST
Stefko
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States.
Juan C
JC
Fernandez-Miranda
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States.
Paul A
PA
Gardner
Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States.
Carl H
CH
Snyderman
Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States.
Eric W
EW
Wang
endonasal; endoscopic; fibrous dysplasia; optic nerve decompression