Optic Nerve Decompression for Compressive Neuropathy Secondary to Neoplasia

Li, Kasey K.; Lucarelli, Mark J.; Bilyk, Jurij R.; Joseph, Michael P.

doi:10.1001/archotol.1997.01900040061010

Cited by 18 publications

(7 citation statements)

References 26 publications

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“…There were 25 studies 5,12,[19][20][21][22][23]25,[27][28][29][30][31][33][34][35][36][37][38][39][40][43][44][45]47 reporting gender data with vision outcome, comprising 658 patients. Overall odds of improvement for male versus female were nonsignificant at 1.07 (95% CI ¼ 0.73 to 1.57).…”

Section: Gendermentioning

confidence: 99%

“…There were eight studies 4,35,36,[38][39][40]43,47 with continuous data for duration of preoperative vision loss, comprising 150 patients. Two studies 4,39 had outlier data with patients with > 84 months of symptoms (n ¼ 3) and were excluded due to the low numbers at the very high end tending to skew the curve and make the upper end unreliable.…”

Section: Duration Of Vision Lossmentioning

confidence: 99%

“…There were 14 studies 4,22,30,[35][36][37][38][39]42,43,45,47,48,67,68 with 323 patients who had both preoperative vision level and postoperative vision level reported, allowing for linear regression to determine the degree of recovery. In patients where both eyes were considered, intrapatient similarity was controlled for.…”

Section: Severity Of Vision Lossmentioning

confidence: 99%

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Predictive Factors for Vision Recovery after Optic Nerve Decompression for Chronic Compressive Neuropathy: Systematic Review and Meta-Analysis

2012

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Objectives?Surgical optic nerve decompression for chronic compressive neuropathy results in variable success of vision improvement. We sought to determine the effects of various factors using meta-analysis of available literature. Design?Systematic review of MEDLINE databases for the period 1990 to 2010. Setting?Academic research center. Participants?Studies reporting patients with vision loss from chronic compressive neuropathy undergoing surgery. Main outcome measures?Vision outcome reported by each study. Odds ratios (ORs) and 95% confidence intervals (CIs) for predictor variables were calculated. Overall odds ratios were then calculated for each factor, adjusting for inter study heterogeneity. Results?Seventy-six studies were identified. Factors with a significant odds of improvement were: less severe vision loss (OR 2.31[95% CI?=?1.76 to 3.04]), no disc atrophy (OR 2.60 [95% CI?=?1.17 to 5.81]), smaller size (OR 1.82 [95% CI?=?1.22 to 2.73]), primary tumor resection (not recurrent) (OR 3.08 [95% CI?=?1.84 to 5.14]), no cavernous sinus extension (OR 1.88 [95% CI?=?1.03 to 3.43]), soft consistency (OR 4.91 [95% CI?=?2.27 to 10.63]), presence of arachnoid plane (OR 5.60 [95% CI?=?2.08 to 15.07]), and more extensive resection (OR 0.61 [95% CI?=?0.4 to 0.93]). Conclusions?Ophthalmologic factors and factors directly related to the lesion are most important in determining vision outcome. The decision to perform optic nerve decompression for vision loss should be made based on careful examination of the patient and realistic discussion regarding the probability of improvement.

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Section: Gendermentioning

confidence: 99%

Section: Duration Of Vision Lossmentioning

confidence: 99%

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Predictive Factors for Vision Recovery after Optic Nerve Decompression for Chronic Compressive Neuropathy: Systematic Review and Meta-Analysis

2012

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“…Indirect decompression may also be appropriate: endoscopic transethmoidal decompression of the posterior intraorbital and intracanicular segments can usefully be achieved for otherwise inoperable sphenoid meningiomas impinging on the optic nerve from the superolateral aspect (Figure 4). [47][48][49][50] In conclusion, the optic canal may be decompressed as part of the treatment of an extrinsic compressing tumour ( Table 2). In the case of fibrous dysplasia, surgery is usually most appropriate for secondary mass lesions and in traumatic optic neuropathy for delayed secondary visual loss in an otherwise fit patient.…”

Section: Neoplastic and Other Compressive Lesionsmentioning

confidence: 99%

Optic nerve disorders: role of canal and nerve sheath decompression surgery

Acheson

2004

Eye

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Optic nerve sheath decompression (ONSD) maintains a role in the management of visual loss complicating papilloedema in selected patients primarily with idiopathic intracranial hypertension. The evidence base for this intervention is reviewed and audit data on visual outcomes for patients with acute, chronic, and atrophic forms of papilloedema are contrasted. Optic canal decompression has a role in the management of compressive optic neuropathies complicating mass lesions arising from paranasal sinuses and intracranially and can be achieved by transethmoidal, transbasal, and open craniotomy routes. The evidence base supporting this intervention in traumatic optic neuropathy and in primary bone disease causing canal stenosis (in particular fibrous dysplasia) is reviewed where the indications are more controversial.

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“…An endonasal approach was chosen, but the endoscopic view could not present an adequate operative field for managing the optic nerve because of the easily bleeding tumor. Li et al 4 reported 30 cases with compressive optic neuropathy secondary to neoplastic processes. They treated the cases with extracranial optic nerve decompression, and 20 of 30 patients showed improvement in vision.…”

Section: Discussionmentioning

confidence: 99%

A case of metastases to the paranasal sinus from rectal mucinous adenocarcinoma

Tanaka

2006

Int J Clin Oncol

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Metastases of malignancies to the sinonasal tract are rare. We report a case of metastases to the paranasal sinus from rectal adenocarcinoma. A 72-year-old woman, who had a history of therapy with rectal adenocarcinoma, came to our hospital for visual loss in her right eye. Computed tomography revealed soft tissue in the right paranasal sinus. She underwent endoscopic sinus surgery immediately and an easily bleeding tumor was found in the paranasal sinus. Magnetic resonance imaging showed a mass involving the posterior ethmoid, the sphenoid sinus, and the orbit. From the surgical specimen, we found that the tumor was a metastasis of a previously managed rectal mucinous adenocarcinoma. Metastatic carcinomas of the sinonasal tract have a high risk of heavy hemorrhage during endoscopic sinus surgery. When a patient with visual loss has a history of malignancy, a possible metastatic tumor should be considered before surgery.

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Optic Nerve Decompression for Compressive Neuropathy Secondary to Neoplasia

Cited by 18 publications

References 26 publications

Predictive Factors for Vision Recovery after Optic Nerve Decompression for Chronic Compressive Neuropathy: Systematic Review and Meta-Analysis

Predictive Factors for Vision Recovery after Optic Nerve Decompression for Chronic Compressive Neuropathy: Systematic Review and Meta-Analysis

Optic nerve disorders: role of canal and nerve sheath decompression surgery

A case of metastases to the paranasal sinus from rectal mucinous adenocarcinoma

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