Endoscopic Approach to Traumatic Visual Loss

Kountakis, Stilianos E.; Maillard, Alberto A. J.; Urso, Richard G.; Stiernberg, Charles M.

doi:10.1016/s0194-5998(97)70243-2

Cited by 41 publications

(24 citation statements)

References 8 publications

(20 reference statements)

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“…To be presented at the ARS Annual Meeting, on September 27, 2015, in Dallas, TX E ndoscopic orbital surgery represents the next frontier in endonasal surgery. The feasibility of endoscopic management of periorbital pathology including orbital 1 and optic nerve decompression 2 were first reported over 25 years ago. Over the next decade the first descriptions of endonasal approaches within the intraconal space began to appear in the literature.…”

mentioning

confidence: 99%

Endoscopic endonasal orbital cavernous hemangioma resection: global experience in techniques and outcomes

Bleier

Castelnuovo

Battaglia

et al. 2015

Int Forum Allergy Rhinol

112

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Extraconal lesions were managed similarly; however, greater variability was evident for intraconal lesions. These included the laterality and number of hands in the approach, methods of medial rectus retraction, and the need for reconstruction. The increased technical complexity and disparity of techniques in addressing intraconal OCHs suggests that continued research into the optimal management of this subclass of lesions is of significant priority.

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mentioning

confidence: 99%

Endoscopic endonasal orbital cavernous hemangioma resection: global experience in techniques and outcomes

Bleier

Castelnuovo

Battaglia

et al. 2015

Int Forum Allergy Rhinol

112

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“…1,7,10,14,26,36,43,58 This technique definitely provides excellent exposure of the optic canal and orbital apex in a minimally invasive fashion. While decompression in traumatic optic neuropathy has been widely investigated, 11,13,[18][19][20]24,28,29,36,37,40,47,48,[52][53][54][55][56][57][58][59]61 indeed with debatable results, decompression for nontraumatic optic neuropathies (NONs) is still insufficiently studied. 2,3,5,12,15,17,[21][22][23][25][26][27]33,35,36,39,41,42,45,46,…”

mentioning

confidence: 99%

Endoscopic endonasal optic nerve and orbital apex decompression for nontraumatic optic neuropathy: surgical nuances and review of the literature

Berhouma

Jacquesson

Abouaf³

et al. 2014

FOC

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Object While several approaches have been described for optic nerve decompression, the endoscopic endonasal route is gaining favor because it provides excellent exposure of the optic canal and the orbital apex in a minimally invasive manner. Very few studies have detailed the experience with nontraumatic optic nerve decompressions, whereas traumatic cases have been widely documented. Herein, the authors describe their preliminary experience with endoscopic endonasal decompression for nontraumatic optic neuropathies (NONs) to determine the procedure’s efficacy and delineate its potential indications and limits. Methods The medical reports of patients who had undergone endoscopic endonasal optic nerve and orbital apex decompression for NONs at the Lyon University Neurosurgical Hospital in the period from January 2012 to March 2014 were reviewed. For all cases, clinical and imaging data on the underlying pathology and the patient, including demographics, preoperative and 6-month postoperative ophthalmological assessment results, symptom duration, operative details with video debriefing, as well as the immediate and delayed postoperative course, were collected from the medical records. Results Eleven patients underwent endoscopic endonasal decompression for NON in the multidisciplinary skull base surgery unit of the Lyon University Neurosurgical Hospital during the 27-month study period. The mean patient age was 53.4 years, and there was a clear female predominance (8 females and 3 males). Among the underlying pathologies were 4 sphenoorbital meningiomas (36%), 3 optic nerve meningiomas (27%), and 1 each of trigeminal neuroma (9%), orbital apex meningioma (9%), ossifying fibroma (9%), and inflammatory pseudotumor of the orbit (9%). Fifty-four percent of the patients had improved visual acuity at the 6-month follow-up. Only 1 patient whose sphenoorbital meningioma had been treated at the optic nerve atrophy stage continued to worsen despite surgical decompression. The 2 patients presenting with preoperative papilledema totally recovered. One case of postoperative epistaxis was successfully treated using balloon inflation, and 1 case of air swelling of the orbit spontaneously resolved. Conclusions Endoscopic endonasal optic nerve decompression is a safe, effective, and minimally invasive technique affording the restoration of visual function in patients with nontraumatic compressive processes of the orbital apex and optic nerve. The timing of decompression remains crucial, and patients should undergo such a procedure early in the disease course before optic atrophy.

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“…reported the first application of endoscopic intranasal reconstruction of the medial orbital wall [3]. High-resolution endoscopes and the advent of endoscopic instruments for sinus surgery now provide the surgeon with excellent endonasal visualization and access to the orbital walls without major complications [9]. Malhotra et al .…”

Section: Discussionmentioning

confidence: 99%

Isolated trapdoor-type medial blowout fracture in an adult presenting horizontal diplopia treated by endoscopic endonasal approach

Noh

Park

Kim

et al. 2013

Journal of Surgical Case Reports

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Orbital blowout fracture frequently occurs along the floor or medial aspect of the orbital wall, which are the two thinnest areas of the bony orbit. True trapdoor injury of the orbit is less common and is rare as an isolated medial wall injury, because the medial orbital wall has several bony septa within the ethmoid sinus that provide support and decrease the risk of a trapdoor fracture. Additionally, the incidence of trapdoor-type blowout fracture in adults is lower than in children. In a trapdoor-type blowout fracture with restricted ocular movement, prompt diagnosis and early intervention are associated with better clinical outcomes. We encountered a case of trap door-type medial blowout fracture with horizontal eye ball movement limitation in an adult. She underwent endonasal endoscopic reduction surgery for the medial blowout fractures. Here we report this case, and suggest early diagnosis and prompt surgical exploration.

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Endoscopic Approach to Traumatic Visual Loss

Abstract: The endoscopic approach may be used to successfully decompress the optic nerve in traumatic blindness.

Cited by 41 publications

References 8 publications

Endoscopic endonasal orbital cavernous hemangioma resection: global experience in techniques and outcomes

Endoscopic endonasal orbital cavernous hemangioma resection: global experience in techniques and outcomes

Endoscopic endonasal optic nerve and orbital apex decompression for nontraumatic optic neuropathy: surgical nuances and review of the literature

Isolated trapdoor-type medial blowout fracture in an adult presenting horizontal diplopia treated by endoscopic endonasal approach

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