Microsurgical anatomy of the optic canal: correlates to optic nerve exposure

Habal, Mutaz B.; Maniscalco, Jack E.; Rhoton, Albert L.

doi:10.1016/0022-4804(77)90036-1

Cited by 55 publications

(42 citation statements)

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“…The nose, eyes, nasopharynx and basis cranii are closely connected in anatomy; therefore, diseases of the noses, eyes, nasopharynx and basis cranii could be involved with each other [1][2][3]. Along with the development in studies of optic nerve anatomy and its injury mechanism, decompression of the optic nerve has been gradually applied in the treatment for traumatic optic nerve injuries [2,4,5].…”

Section: Discussionmentioning

confidence: 98%

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Study on the treatment of traumatic orbital apex syndrome by nasal endoscopic surgery

Xiao

et al. 2010

Eur Arch Otorhinolaryngol

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Orbital apex syndrome (OAS) is a complex disease caused by a variety of pathological factors, and trauma is one of the main factors/causes. Clinical data of 17 cases of traumatic OAS treated by nasal endoscopic surgery in our department from January 2002 to April 2009 were gathered and reviewed. Among them, the six patients presented with OAS after injury to the lateral wall of orbital apex. Seven other patients exhibited OAS after injury to the medial wall of orbital apex, two displayed OAS after zygomatic trauma, while OAS manifested in the other two patients with craniocerebral trauma 3 days after they had decompressive craniotomy--of them, one was blind in both eyes. In the 17 cases, 6 patients were without light sensation, 1 was blind in both eyes; the sight-chart index of eight patients was 0.1, that of three other patients was 0.1-0.2. Fifteen patients displayed eyeball movement disturbance (disorder) and cornea sensory disturbance (disorder), two were with the eyeball abducent disturbance. After the nasal endoscopic surgeries for OAS performed on the 17, the sight of the most patients was restored in varying degrees. The sight of nine patients was between 0.2 and 0.3, that of two patients was between 0.1 and 0.2, that of the other two patients was 0.1, and that of four patients remained unchanged. The eyeball movement and the cornea esthesia in 15 patients recovered from the surgeries, one patient recovered with good eyeball adducent movement and the cornea esthesia but with eyeball abducent disturbance, the other patient did not make a recovery from the eyeball immobility, cornea anesthesia and ptosis. A follow-up lasting 2 months to 2 years suggested that the 16 patients had stable recovery from the surgeries. Satisfactory results could be achieved in the treatment of traumatic OAS by nasal endoscopic surgery. From objective assessment of the therapeutic effects of traumatic OAS, it can be concluded that if a patient is diagnosed with fractures of the optic canal and the superior and medial walls of orbital apex, nasal endoscopic decompression of superior and medial walls of orbital apex and optic canal via the approach to the sphenoid and ethmoid sinuses is the most ideal operative therapy.

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Section: Discussionmentioning

confidence: 98%

“…Ophthalmoplegia, facial numbness and visual damage [1][2][3][4] are among its general symptoms since injuries to I, III, IV, V and VI cranial nerves. OAS is usually caused by trauma, foreign bodies, fungi, cephalic and facial infections and tumor invasion of the orbital apex, and trauma is one of the main causes.…”

Section: Introductionmentioning

confidence: 99%

Study on the treatment of traumatic orbital apex syndrome by nasal endoscopic surgery

Xiao

et al. 2010

Eur Arch Otorhinolaryngol

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“…Esta variação pode ser devida à incapacidade da tomografia computadorizada detectar espessuras ósseas com menos de 0,5mm 14 . Alguns autores 11,[13][14][15][16] relataram que a cobertura ós-sea separando o seio esfenoidal do nervo óptico em alguns casos é menor do que 0,5mm de espessura. Delano et al 10 encontraram deiscência no trajeto do nervo óptico tipo 1 em 7% dos casos; no tipo 2 em 82% e nos tipos 3 e 4 em 100% e 11,11% respectivamente.…”

Section: Discussionunclassified

Relação anatômica do nervo óptico com o seio esfenoidal: estudo por tomografia computadorizada

Dias¹,

Albernaz

Yamashida

2004

Rev. Bras. Otorrinolaringol.

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O seio esfenoidal entre os seios da face é certamente o mais negligenciado quanto ao diagnóstico. A abordagem cirúrgica requer conhecimento anatômico detalhado, levandose em conta as graves complicações decorrentes de lesões de estruturas vitais adjacentes a esta região. Objetivo: O objetivo do nosso estudo é avaliar a relação anatômica do canal do nervo óptico com o seio esfenoidal utilizando a tomografia computadorizada. Forma de estudo: Análise de série. Material e Método: Os autores apresentam a análise retrospectiva de 202 tomografias computadorizadas de seios da face de indiví-duos de ambos os sexos com idade igual ou superior a 14 anos. Os exames foram avaliados observando o trajeto do canal do nervo óptico obtido pelo grau de projeção na parede do seio esfenoidal. Foi utilizada a classificação modificada de Delano. Foi avaliada a ausência de atenuação óssea (deiscência) do canal do nervo óptico no seio esfenoidal. O grau de pneumatização do seio esfenoidal foi analisado, sendo empregado a classificação de Hammer's adaptada por Guerrero, além da pneumatização do processo clinóide anterior e pterigóide e a presença da célula de Onodi. Resultados: A maioria dos pacientes (78.96%) apresentou o canal do nervo óptico com trajeto do tipo 1, o tipo 2 foi observado em 16.83%, o tipo 3 em 3.47% e o tipo 4 em 0.74%. A presença de deiscência do nervo óptico na parede do seio esfenoidal foi evidenciada em 21.29% dos casos. Em relação à pneumatização, notamos que o tipo pré-selar foi observado em 6.44%, o tipo selar em 39.11%, o tipo selar em 54.45%, e o tipo apneumatizado não foi observado em nossos casos. A pneumatização do processo clinóide anterior foi constatado em 10.64% enquanto do processo pterigóide em 21.29% dos casos, a célula de Onodi foi verificada em 7.92% dos casos. Conclusão: A presença de deiscência do canal do nervo óptico está relacionado com o grau de pneumatização dos processos clinóide anterior e processo pterigóide, a presença de célula de Onodi e os tipos de trajeto 2, 3 e 4 da relação do nervo óptico com o seio esfenoidal. The sphenoid sinus, out of the facial sinuses, is certainly the most neglected as far as diagnosis is concerned. The surgical approach requires a detailed anatomical knowledge, considering the serious complications resulting from injuries of vital structures adjacent to this region. Aim: The objective of our research is to evaluate the anatomic relationship of the optic nerve with the sphenoid sinus making use of the computed tomography. Study design: Serie report. Material and Method: The authors present a retrospective analysis of 203 computed tomographies of facial sinus belonging to individuals of both sexes aged 14 and over. The examinations were evaluated observing the course of the optic nerve, obtained through the degree of its projection on the wall of the sphenoid sinus. The method used was the modified classification of Delano, evaluating the absence of bone reduction (dehiscence) of the optic nerve in the sphenoid sinus. We analysed the degree of pneumatization o...

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“…However, intranasal access to the brain carries risk of injuring the optic nerve meninges or perforating the internal carotid artery going up to the encephalic base, which can cause obstruction of the lachrymal canal. [1][2][3][4] Although endoscopic interventions have been carried out on children, biometric studies of the optic canal in children are few and the data they bring are sometimes conflicting.…”

Section: Introductionmentioning

confidence: 98%

Biometric Study of the Optic Canal during Cranial Development

Prado

Ribeiro

Angelis

et al. 2007

Orbit

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To study optic canal dimensions and symmetry during cranial development, 146 silicon rubber left- and right-side models of the optic canal were cast from 51 dry skulls and 22 individual bones. The sample was divided in three age groups: fetuses (including newborns), children and adults with ages ranging from seven months of fetal life to 68-year-old. A digital caliper was used to measure the optic canal orbital and cranial diameters as well as model length. Results for the right and the left sides were, respectively, in millimeters: a) Maximum diameter of the orbital opening: fetuses, 4.68/4.47--children, 5.51/5.41--adults, 5.43/5.34; b) Minimum diameter of the orbital opening: fetuses, 2.89/2.84--children, 3.54/3.61--adults, 3.78/3.73; c) Diameter of the cranial opening: fetuses, 3.79/3.76--children, 4.67/4.72--adults, 5.24/5.43; d) Length of the optic canal: fetuses, 3.27/3.05--children, 3.93/3.71--adults 4.94/5.21. The diameter of the cranial opening of the optic canal increases significantly (p < 0.001) during the fetal period and throughout child and adulthood. The greater and smaller orbital apertures increase during the fetal period and during childhood, keeping the same size in adulthood. Optic canal length increases at some point between childhood and adulthood. Concerning symmetry, the only significant difference found was greater right than left optic canal diameter on the orbital side.

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Microsurgical anatomy of the optic canal: correlates to optic nerve exposure

Cited by 55 publications

References 1 publication

Study on the treatment of traumatic orbital apex syndrome by nasal endoscopic surgery

Study on the treatment of traumatic orbital apex syndrome by nasal endoscopic surgery

Relação anatômica do nervo óptico com o seio esfenoidal: estudo por tomografia computadorizada

Biometric Study of the Optic Canal during Cranial Development

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